Wheelchair Recipients’ Perceived Barriers to In-person and Virtual Follow-up Consultations: A Cross-sectional Study

Abstract

Background. The Philippine General Hospital (PGH) is a tertiary government hospital that serves as the national referral center for Filipinos from across the country. In partnership with Latter-Day Saint Charities (LDSC), PGH has been serving patients in need of mobility devices, such as wheelchairs, through in-person services from screening to assessment, measurement, assembly, fitting, and mobility training. Given the patients’ barriers to in-person follow-up consultations, regular healthcare provision has been challenging. The use of telerehabilitation, a form of telemedicine, has emerged as a practical and innovative solution, but it needs further evaluation.

Objectives. The study aimed to determine the wheelchair recipients’ perceived barriers to in-person and virtual follow-up consultations.

Methods. This cross-sectional study involved a purposive sample of 413 patients who received a wheelchair from the LDSC through PGH. An original survey was prepared to determine patients’ perceived barriers to actual in-person and potential virtual follow-up consultations Consent was obtained prior to data collection. After the pretest and pilot testing were conducted, the final version of the survey was administered either electronically or through individual phone interviews. Descriptive statistics was used to analyze and present the data.

Results. A total of 113 wheelchair recipients participated, with an average of 42.9 years of age. The majority resided outside Metro Manila (53.1%), and 86.7% were within the income bracket of less than PhP 9,520 per month. The majority received a standard type of wheelchair (85.8%). The top 3 reasons hindering compliance to in-person consultation follow-ups were accessibility issues (82.3%), costs of travel (79.6%), and distance to hospital/wheelchair assessor (71.7%). With respect to potential virtual follow-ups, 72% expressed willingness to experience telemedicine/ telerehabilitation in the future, despite having neither prior awareness (50.4%) nor experience (74.3%) of it. The majority had access to mobile phones (98.2%), and 67% had stable internet access.

Conclusion. The main barriers to in-person follow-ups were related to accessibility, costs, and travel. Telehealth or telerehabilitation in particular, despite patients’ interest and willingness to try it, still has yet to be optimized in our country. Internet connectivity can still be improved, as well as our stakeholders’ level of telehealth awareness. Future efforts to improve and sustain the uptake of telehealth solutions are recommended, as well as studies comparing the cost-effectiveness of in-person versus virtual consultations especially among persons with lived experiences of disability.