Study calls for increased research for complex rehab

Thursday, February 2, 2012

MINNEAPOLIS - A lack of research relating to complex rehab could put funding in danger, according to a report from the Agency for Healthcare Research and Quality (AHRQ).

That's no surprise to Mark Schmeler, a University of Pittsburgh professor who has been working to improve research efforts for years.

"We're trying to find better ways to provide wheelchairs and prove (our efficacy) to the government, so they don't keep cutting us," he said. "We've always been trumped by other areas of health care that have higher priority."

Minnesota Evidence-based Practice Center created the Wheeled Mobility (Wheelchair) Service Delivery technical report for the AHRQ at the suggestion of the Medicaid Medical Directors Learning Network.

The network sought a report on the "state of the science" of complex rehab, says Nancy Greer, one of the report's authors.

"Our goal was to describe the wheeled mobility service delivery process, provide an overview of the published evidence on service delivery and identify issues and areas for future research," she said. "Ultimately, we are describing the state of the evidence, and doing so could lead to improved wheeled mobility assessment and delivery."

The report found that, while there is a generally recommended service delivery process for complex rehab, there is a lack of research into its efficacy, which potentially puts funding in danger.

"Without evidence of effectiveness, healthcare systems may not feel obligated to offer specialty clinics and ongoing services, and third-party payers have no rationale for funding the recommended steps," the report states. 

Schmeler believes UPitt and NRRT's recent work to collect outcomes data for complex rehab could go a long way to fill some of the gaps in research.

"Doing large, multi-site trials, like we're already doing with the outcome measures, and creating a national registry or national database so we have large sample sizes would let us start looking at different trends or comparing different types of service delivery," he said.