Epidemiology of Medicare Abuse: The Example of Power Wheelchairs
Article first published online: 18 JAN 2007
Journal of the American Geriatrics Society
Volume 55, Issue 2, pages 221–226, February 2007
How to Cite
Goodwin, J. S., Nguyen-Oghalai, T. U., Kuo, Y.-F. and Ottenbacher, K. J. (2007), Epidemiology of Medicare Abuse: The Example of Power Wheelchairs. Journal of the American Geriatrics Society, 55: 221–226. doi: 10.1111/j.1532-5415.2007.01063.x
- Issue published online: 18 JAN 2007
- Article first published online: 18 JAN 2007
- power wheelchair;
OBJECTIVES: To determine the effect of neighborhood ethnic composition on power wheelchair prescriptions.
DESIGN: The 5% noncancer sample of Medicare recipients in the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database, from 1994 to 2001.
SETTING: SEER regions.
PARTICIPANTS: Individuals covered by Medicare living in SEER regions without a cancer diagnosis.
MEASUREMENTS: Individual characteristics (age, sex, ethnicity, justifying diagnosis, and comorbidity), primary diagnoses, neighborhood characteristics (percentage black, percentage Hispanic, percentage with <12 years education, and median income), and SEER region.
RESULTS: The rate of power wheelchair prescriptions was 33 times greater in 2001 than in 1994, with a shift over time from justifying diagnoses more closely tied to mobility impairment, such as strokes, to less-specific medical diagnoses, such as osteoarthritis. In multilevel, multivariate analyses, individuals living in neighborhoods with higher percentages of blacks or Hispanics were more likely to receive power wheelchairs (odds ratios=1.09 for each 10% increase in black residents and 1.23 for each 10% increase in Hispanic residents) after controlling for ethnicity and other characteristics at the individual level.
CONCLUSION: These results support allegations that marketers promoting power wheelchairs have specifically targeted minority neighborhoods.