Government-insured children face orthotic treatment delays

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Biomechanics Magazine March 2007

http://www.biomech.com/showArticle.jhtml?articleID=197800999

Government-insured children face orthotic treatment delays

By: Lori Rochelle Roniger

Children covered by government health insurance face longer waits to

receive prescribed orthoses than children covered by either

preferred-provider or health-maintenance organizations, according to

a study published in the January/February issue of the Journal of

Pediatric Orthopaedics.

The study's authors retrospectively reviewed the medical records of

60 children who were prescribed either an ankle foot orthosis or a

thoracolumbosacral orthosis. They randomly chose 10 children who

received an orthosis from the same supplier and were covered by

government, PPO, or HMO insurance.

They found significant differences between insurance types in the

time from prescription to authorization of the orthoses and in the

time from authorization to brace receipt. Children with PPO

insurance received AFO authorization significantly faster than

children with either government or HMO coverage. It also took

significantly longer for children with government coverage to

receive authorization for a TLSO than either HMO- or PPO-covered

children. The time between authorization and procurement of a TLSO

was significantly less for the PPO-insured children (36 days) than

the government-insured children (123 days), according to the study.

The researchers noted that the delay in receiving a TLSO, which

costs approximately four times as much as an AFO, was noticeably

longer for the government-insured children.