title: Understanding the Provision of Assistive Mobility and Daily Living Devices and Service Delivery to Veterans After Stroke.
abstract: OBJECTIVE
  The objective of this study was to determine whether facility-level, structural factors affect the provision of assistive devices and services.
  
  
  METHODS
  A retrospective design was used. Activities of daily living and mobility-related devices were categorized into 11 types. Logistic regression models were performed for each type of device, controlling for patient-level and facility-level covariates.
  
  
  RESULTS
  Non-veteran-level factors significantly affect the provision of assistive devices, even after covariate adjustment. Increased rehabilitation clinician staffing by 1 full-time equivalent position was associated with increased provision odds of 1%-5% for 5 of 11 types of devices. Lower facility complexity was significantly associated with increased provision odds of 35%-59% for 3 types of devices and with decreased provision odds of 16%-69% for 3 types of devices.
  
  
  CONCLUSIONS
  System-level factors, in addition to patient need, significantly affect the provision of assistive devices. Provision guidelines could assist clinicians in making decisions about device provision.
authors.affiliation: John A. Kairalla, PhD, is Assistant Professor, Department of Biostatistics, University of Florida, Gainesville.
authors.forename: John A
authors.initials: JA
authors.lastname: Kairalla
authors.affiliation: Sandra L. Winkler, PhD, OTR/L, is Research Health Science Specialist, James A. Haley Veterans' Hospital Center of Innovation in Disabilities and Rehabilitation Research, Tampa, FL.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Winkler
authors.affiliation: Hua Feng, MS, is Senior Biostatistician, Veterans Affairs (VA) Health Services Research & Development Center of Innovation, Michael E. DeBakey VA Medical Center, Houston, TX, and Senior Biostatistician, Department of Medicine, Baylor College of Medicine, Houston, TX.
authors.forename: Hua
authors.initials: H
authors.lastname: Feng
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002183:Canes; D005260:Female; D006787:Hospitals, Veterans / Q000145:classification / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D012656:Self-Help Devices / Q000706:statistics & numerical data*; D000071939:Stroke Rehabilitation; D014728:Veterans; D014910:Wheelchairs