Breakdown study: Wheelchairs at risk

PITTSBURGH - A recent study found that 53% of wheelchair users reported one or more breakdowns that required repairs in a six-month period, with Medicare and Medicaid patients the most affected.

Lead researcher Dr. Michael Boninger, chair of the Department of Physical Medicine and Rehabilitation at the University of Pittsburgh, said he wasn't surprised that wheelchairs, especially the more complex ones, have a high breakdown rate, but it doesn't need to be that way.

“The complexity of the most complex wheelchair on the planet doesn't approach the complexity of a car,” said Boninger. “Imagine having half of the new cars out there requiring repair in a six month period of time.”

The study, published in the American Journal of Physical Medicine & Rehabilitation in June, analyzed the wheelchair breakdown rates of more than 700 wheelchair-dependent spinal cord injury patients who used their wheelchairs at least 40 hours per week. Of those, 53% reported one or more breakdowns that required repairs per six-month period from 2006-11, up from 45% from 2004-06.

Boninger's study also found that wheelchairs funded by Medicare or Medicaid had higher rates of breakdowns and consequences compared to those covered by other sources. He says policies that provide flat payment regardless of the wheelchair quality contribute to wheelchair breakdowns.

“That is not the environment I would want to practice in if I was a home medical equipment provider,” said Boninger. “It's not the environment that I want to practice in as a physician.”

Mark Schmeler, a University of Pittsburgh assistant professor, says the results of the study prove policies need to be changed.

“This puts some responsibility back on the funding sources,” said Schmeler. “If they want to marginalize pricing and force us to prescribe cheap wheelchairs, they have to know there's a cost associated with that.”

Boninger said providers should continue to advocate for higher reimbursement rates and higher-quality chairs.