ABSTRACT 

The provision of AT should be based on patient need. Our research shows unexplained geographical variations in VHA AT delivery that cannot be explained by person-level factors such as diagnosis, severity of disability, or demographics. Of interest are factors that may explain this variation. Rather than asking who is using the technology, we asked if veterans received the same type/quality of technology across the VHA. Our objectives were to determine how: (1) Provision patterns vary for assistive devices for veterans post-stroke, by device and by geographic region and (2) Demographic/clinical characteristics, or geographic region are associated with provision of devices. For standard manual wheelchairs, for example, the amount of variation in device provision accounted for by regional effects is equivalent to the amount of variation accounted for by disability severity. Persistent geographical variation in provision of AT suggests the need for some type of standardization or guidelines concerning device provision.