What determines the possession of assistive devices among patients with rheumatic diseases? The influence of the country-related health care system

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Abstract
To identify the determinants of the possession of assistive devices among patients with various rheumatic conditions. In order to determine the influence of the country-related health care system, patients from two different countries were studied. Patients with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) were selected from rheumatology outpatient clinics in two adjacent regions in The Netherlands and Germany. A total of 142 patients completed a self-administered questionnaire. Information on the possession of assistive devices and data on socio-demographics, clinical status and health status were obtained. Logistic regression analyses were used to identify determinants of the possession of assistive devices. The majority (78%) of the patients possessed at least one or more assistive devices. Obviously, functional status was the most important determinant, followed by the country where the patient resided. More assistive devices were found in increasingly disabled patients as well as in patients living in The Netherlands. Functional status and the patient's country are the most important determinants of the possession of assistive devices among patients with rheumatic conditions. We hypothesize that the most likely explanation for the differences in possession rates between countries are differences in societal systems for the prescription and reimbursement of assistive devices.

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