A narrow interpretation of “medical necessity” can result in poorer health as well as a more restricted life for people with disabilities. We examined the impact of US policy on reimbursement of intermittent catheters (ICs) on the lives of people with neurogenic bladder (NB) who require catheters to urinate. We conducted in-depth, longitudinal interviews with nine stakeholders. Actor-Network Theory was used to describe interactions among human agents, IC products, and policies in the reimbursement arena. Restrictions on the type and quantities of ICs reimbursed emerged as the most potent inhibitor to health and wellbeing among consumers with NB. IC suppliers, due to the large number of other stakeholders with whom they interact in the reimbursement process, emerged as strong enablers of preferred IC use among people with NB. Lack of an impartial central clearinghouse on IC products and coverage impeded consumers’ ability to make informed decisions.
actor-network theory, interpretative phenomenological analysis, disability-competent care, intermittent urinary catheter, neurogenic bladder, reimbursement, spina bifida, spinal cord injury
Authors express their appreciation to Elizabeth F. Davis, consumer expert (spinal bifida) at MedStar Health Research Institute, for her help in the design of the interview guide, conduct of semi-structured interviews, open coding, and editing of the manuscript.
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Recommended APA Citation
Schladen, M. M., Rounds, A. K., McManus, T., Bennewith, A., Claypool, H., & Groah, S. L. (2021). Intermittent Catheter Reimbursement in the United States: The Experience of Nine Stakeholders Through the Lens of Actor-Network Theory. The Qualitative Report, 26(2), 443-464. https://doi.org/10.46743/2160-3715/2021.4660
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