Investigation of stakeholder perceptions of the wheelchair service delivery process.

Abstract

Introduction: The wheelchair service delivery process (SDP) is a large complex system and therefore has many potential points of failure; determining priorities for improvement is challenging. The complexities introduce several barriers to accessing and maintaining wheelchairs for individuals with mobility impairments. Given the breadth and depth of the barriers, it is important to know in which areas to focus future policy reform efforts.

Purpose: The purpose is to explore the perceptions of stakeholders regarding the performance of the wheelchair SDP in the United States and guide future policy reforms.

Methods: A cross-sectional, observational, online questionnaire was deployed. Questions were positive statements regarding the wheelchair SDP and participants rated their agreement with the statements on a standard six-point Likert scale. A snowball sampling strategy was used and consisted of emailing 42 organisations representing 5 stakeholder groups: (1) consumers/caregivers; (2) clinicians; (3) manufacturers; (4) payers; and (5) suppliers.

Results: 1,052 responses were collected: 41% clinicians, 30% suppliers, 24% consumers/caregivers, 3% manufacturers, 2% payers. Stakeholders view the wheelchair SDP as not performing well. Less than 18% of all responses indicate a positive perception. Funding and procurement was viewed in the least positive light, with 5% positive responses. Follow-up, maintenance, and repair was the second least positive component with 9% positive responses. Fitting, training, and delivery was viewed most positively with over 42% positive responses.

Conclusion: The wheelchair SDP is not viewed as performing well by its stakeholders. Funding, procurement, maintenance, and repairs are viewed particularly negatively, representing opportunities for focused system reform efforts.