(131) When tracheostomy supplies run out: Exploring workflows and workarounds for patients and families in Nebraska

Introduction: Timely access to Durable Medical Equipment (DME) is critical for safe home care of people with tracheostomies (PwTs). Supply shortages increase caregiver burden, promote potentially unsafe workarounds, and contribute to poor utilization of healthcare resources. This pilot study examined tracheostomy DME shortages among Medicaid-insured PwTs in Nebraska and how beneficiaries respond when supplies are unavailable.

Methods: PwTs discharged from pediatric and adult hospitals within a regional system completed a 10-minute online survey on post-discharge DME access. Patient surveys were conducted between September 2025 and January 2026. Survey items addressed the frequency of shortages and actions taken to resolve them. Survey response results were reported descriptively using percentages.

Results: A total of 135 patients and caregivers were contacted; the response rate was 16.3% (n=22). Analyses focused on respondents using Medicaid as their insurer (n=19). 68% of respondents reported experiencing a DME shortage. Among those, 62% reported a single occurrence, 31% reported shortages every few months, and 7% reported monthly shortages. When shortages occurred, 53% contacted their DME company, while 47% did not. Among those who contacted their DME company, 56% also used online resources, 33% contacted other patients or caregivers, and 44% used social media. Among those who did not contact their DME company, 20% contacted their clinic or hospital, and 10% used online resources and peer outreach in addition to clinical support.

Conclusions: DME shortages are common among PwTs. Many beneficiaries rely on third-party resources beyond DME providers to resolve supply gaps. Future research will examine systemic, operational, and supply chain contributors to persistent DME shortages.