Objective
The movement and posture problems are always accompanied with the persons with cerebral palsy (CP) and various assisted devices and appliances are needed to compensate those complications such as weakness, contracture and gait disturbance. There is a provision policy of reimburse expenses of the assisted devices and appliances for persons who are registered in disabled in Korea, but the data about current state in persons with CP is lacking. In this study, we would like to investigate the current state of the assisted devices and appliances provision system of the persons with CP who are registered in disabled with brain lesion.
Method
Participants were recruited through database in National Health Insurance Service from January 1st, 2003 to December 31th, 2013. Among those, patients who were diagnosed with CP, whose age were identified and had records of the assisted devices and appliances provision at least once were included in this study. Ankle Foot Orthosis (AFO) and manual wheelchair, the most frequently supported items, are selected in this study and their period of use and re-supply are also evaluated. The age groups of patients are divided into three periods-preschool, school age and adult-as the pattern of orthotics usage might differ depending on their life cycle.
Result
The types of AFO divided into three groups-limited, klenzac and 90° limited according to the National Health Insurance Law and limited AFO was the most frequently supported among them (Table 1). In case of manual wheelchair, total number of supply was 1,802 to preschool children, 3,824 to school aged and 38,153 to adult patients. The electric wheelchair and electric scooter were added to orthosis support list from 2005, most of them were supported to adult patients.
When evaluated at a re-supply status of the orthosis, AFO was supported 1.4~2.1 times on average to preschool children, 1.2~1.6 times to school aged and 1.0~1.3 times to adult patients. Manual wheelchair was supported 1.3 times on average to preschool children, 1.2 times to school aged and 1.0 time to adult patients. In case of electric scooter there was no case of support to preschool children and 1.0 time on average to school age and adult patients. When evaluated at a re-supply duration, the duration was suitable to the reference period of re-supply according to the related law in adult patients but not in preschool and school aged as the actual re-supply duration was much shorter than the reference value (Table 2).
Conclusion
This study confirmed the pattern of the assisted devices and appliances supply was differed depending on the life cycle of the persons with CP. Also it revealed there was a gap between the duration on guideline of regulation and actual duration of re-supply particularly growing periods. It is expected that these results would be used as the baseline data for establishment of policies concerning the assisted devices and appliances provision system to the persons with CP |
