AmbulanzPartner analysis: High regional differences in the rejection rate of aids for ALS

AmbulanzPartner and Charité – Universitätsmedizin Berlin analyzed 1,254 patients with amyotrophic lateral sclerosis (ALS) to determine the rejection rates by health insurance companies and the regional differences in care.


Between March 2011 and March 2014, 7,394 medical aids were prescribed by a specialist neurologist and recorded on the AmbulanzPartner.de internet portal. The rejection rate by health insurance companies was 22.3%. The following frequencies of medical indication and rejection rates were found for ALS-typical assistive devices:

• Orthoses n=863 (9% rejected);
• Communication aids n=561 (26% rejected);
• Exercise trainer n=104 (43% rejected);
• Multifunctional wheelchairs n=203 (40% reject) and
• Electric wheelchairs n=455 (33% rejected).

There were clear regional differences in the refusal rates for power wheelchairs between Berlin (41%), Brandenburg (28%), Mecklenburg-Western Pomerania (33%), Saxony-Anhalt (29%) and Saxony (35%). This means that the relative risk of refusal of a power wheelchair for a patient in Berlin was 1.46 compared to an insured person from the neighboring federal state of Brandenburg.


The high level of rejection in individual aid groups and the regional differences in care indicate a great need for research with health policy relevance.


The detailed data from the study will be presented at the Congress of the German Neurological Society (DGN) in Munich in September 2014.


About the AmbulanzPartner care network
The AmbulanzPartner care network uses a managed care concept to provide medical aids to patients with ALS. The Internet portal AmbulanzPartner.de enables the digitization of care processes and the recording of real data on the provision of medical aids.


About amyotrophic lateral sclerosis (ALS)

ALS is a prototypical disease for complex assistive technology including orthotics, electromobility and assisted communication. Despite the high demand and widespread use, there are no systematic studies on the provision of assistive devices for ALS.