An observational study of powered wheelchair provision in Italy

ABSTRACT

Powered wheelchairs are complex and expensive assistive devices that must be selected and configured on the basis of individual user needs, lifestyle, motivation, driving ability, and environment. Providing agencies often require evidence that their financial investment will lead to a successful outcome. The authors surveyed a sample of 79 users who had obtained powered wheelchairs from a Regional Health Service in Italy in the period 2008–2013. Follow-up interviews were conducted at the users’ homes in order to collect information about wheelchair use, and its effectiveness, usefulness, and economic impact. The instruments used in the interviews included an introductory questionnaire, QUEST (Quebec User Evaluation of Satisfaction with Assistive Technology), PIADS (Psychosocial Impact of Assistive Devices Scale), FABS/M (Facilitators and Barriers Survey/Mobility), and SCAI (Siva Cost Analysis Instrument). The results indicated positive outcomes, especially in relation to user satisfaction and psychosocial impact. A number of barriers were identified in various settings that sometimes restrict user mobility, and suggest corrective actions. The provision of a powered wheelchair generated considerable savings in social costs for most users: an average of about $38,000 per person over a projected 5-year period was estimated by comparing the cost of the intervention with that of non-intervention.

KEYWORDS:

• assistive technology
• cost-effectiveness
• follow-up
• outcome assessment
• powered wheelchairs

Acknowledgments

The authors wish to thank the Scientific Direction of IRCCS Fondazione Don Carlo Gnocchi for their support, the colleagues of the DAT Service who collaborated in recruiting the patients and administering the interviews (Chiara Maglia, Maria Rivetti, Maria Silva, Ylenia Tosi, Antonio Caracciolo, and Ingela Johnson), and colleague Maddalena Plebani who collaborated to data processing. The authors are especially grateful to all persons who accepted to be interviewed and provided precious information.

Funding

The POWER Study has been partially funded by the Italian Ministry of Health within the 2014 ongoing research fund granted to IRCCS Fondazione Don Gnocchi.

Additional information

Funding

The POWER Study has been partially funded by the Italian Ministry of Health within the 2014 ongoing research fund granted to IRCCS Fondazione Don Gnocchi.