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Associations Between Insurance Provider and Assistive Technology Use for Computer and Electronic Devices 1 Year After Tetraplegia: Findings From the Spinal Cord Injury Model Systems National Database

      Abstract

      Objective

      To investigate the association between insurance provider and reported assistive technology (AT) use to access computers and electronic devices 1 year after sustaining tetraplegia.

      Design

      Multicenter cross-sectional study.

      Setting

      Participants enrolled in the Spinal Cord Injury Model Systems (SCIMS) National Database.

      Interventions

      Not applicable.

      Participants

      Men and women with tetraplegia (N=498) enrolled in the SCIMS National Database were included in the analysis.

      Main Outcome Measures

      The primary study outcome was the use of AT when operating a computer or other mobile electronic device. The primary predictor was the subject’s principal health insurance provider, which was grouped into the 3 categories: government (Medicare, Medicaid, and other government), private (private insurance, private funds, and other), and workers’ compensation.

      Results

      Overall, 34.7% of participants reported using AT to access computers and electronic devices. Results of logistic regression analysis revealed sex, injury level, injury completeness, self-perceived health status, and 12-month history of pressure ulcer were all significantly associated with AT use. After adjusting for these factors, participants with workers’ compensation were more likely to report AT use than individuals with either government or private insurance.

      Conclusions

      Despite significant technological advances, AT is not readily available to the people who might benefit most from its use. Findings from the present study are the first to shed light on AT funding sources and reveal that individuals with workers’ compensation are more likely use AT than individuals with either government or private insurance. Additional work focused on AT use and functional outcomes is needed to assess the effect of barriers to use. Collectively, this work may inform insurers of the importance of having AT available for this unique population to potentially improve quality of life and participation.

      Keywords

      List of abbreviations:

      AIS (American Spinal Injury Association Impairment Scale), AT (assistive technology), OR (odds ratio), SCI (spinal cord injury), SCIMS (Spinal Cord Injury Model Systems)
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