[Phase specific technical aids prescription in neurological rehabilitation]

Abstract

Objective: The purpose of this study was to gain a phase specific survey concerning amount, types and costs of technical aids (TA) in a German neurological rehabilitation centre. Further, a number of common rehabilitation outcome parameters were to be related to technical aids provision.

Design: A prospective study included all patients (N = 509) with stroke, traumatic brain injury (TBI), brain tumour and multiple sclerosis (MS) admitted within a two-year period to the Klinik Berlin. The TAs prescribed were registered separately for each phase concerning type, amount and costs. In all, 108 different technical aids were recorded, and the direct costs for these technical aids were calculated. Outcome parameters used were the Barthel Index (BI) at admission and discharge, length of stay, and discharge destination.

Results: The mean (median) length of stay in phase B (C) was 76 (56) days with a mean (median) increase of BI score of 25 (15) points. Patients in phase D staid 35 days (median) at the clinic, their BI had been 100 points (median) already on admission. 93,3 % of all patients returned home (phase B and C 78,2 %). On average, patients in phase B and C received 2 technical aids/person, in phase D the median was 0 technical aid/person. On discharge, patients in phase B had an average of 3 technical aids/person, phase C patients had 4,5 TA/person and phase D patients 1 technical aid/person (median). The mean cost of a technical aid was 670 DM in phase B, 405 DM in phase C, and 290 DM in phase D (median).

Conclusion: Technical aids are important components in rehabilitation, especially for severely affected patients, who receive the most expensive technical aids such as wheelchairs and bath tub lifters. High competence in questions related to technical aids is absolutely indispensable for any unit dealing with these patients. On the other hand, less affected patients mostly receive walking aids and grab bars. Future studies should deal with utilization rates and satisfaction with technical aids at home, as well as with cost-effectiveness issues.