The 130th Annual Meeting of APHA

Abstract #48489

Bonnie O'Day, PhD, CESSI, 2455 North Stevens Street, Alexandria, VA 22311, 703 845 3436, mkilleen@pipeline.com and Lisa I. Iezzoni, MD, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Libby-326, Boston, MA 02215.

This study examined quality of care for individuals with disabilities along various dimensions of healthcare, including access to care; use of primary, preventive, and specialty care; and satisfaction with care. We examined responses from 16,403 Medicare beneficiaries living in the community through the 1996 Medicare Current Beneficiary Survey (MCBS). In addition, in order to obtain personal perspectives on access to and quality of health care, we conducted 17 structured focus groups in both urban and rural areas, with a total of over 100 participants. Focus groups included people who are either Deaf, hard of hearing, blind or have low vision, and persons with major mobility difficulties or serious mental health problems. Findings: About 9.7 percent of people with major difficulties in walking, grasping, reaching overhead, seeing, or hearing reported dissatisfaction with the adequacy of information physicians had about their conditions, as compared with 3.7 percent of people without these difficulties. Costs were the major barrier to accessing care, followed by inconvenience in getting to the doctor. Blind persons reported the most difficulty with obtaining care; people who are Deaf or hard of hearing were most likely to report problems with telephone access to physicians. Focus groups revealed issues in several areas, including access to doctor’s offices and equipment; access to printed information and telephone contact; physician knowledge about the disability and how it relates to the current reason for seeking treatment; physician knowledge about assistive technology and community resources; and staff etiquette in examining and treating people with disabilities.

Learning Objectives: At the conclusion of this session, the participant will be able to

• Describe the barriers people with various disabilities face in receiving high quality health care.
• Articulate the specific concerns people with disabilities have about health care quality as reported in the 1996 MCBS.
• Identify solutions within the medical setting that address these barriers and concerns.

Keywords: Disability, Health Care Quality

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.