Effect of patient disabilities on imaging utilization

Objective: To examine the role of patient disabilities on the utilization of mammography in the United States.

Persons with disabilities are a large sector of the population that needs health care services. According to the CDC, about 50 million people in the U.S. have a disability, such as physical limitations, mental disability, hearing loss, or vision loss. Health care facilities may be inaccessible or not have the appropriate equipment to serve persons with disabilities, or have untrained staff. Persons with disabilities may be reluctant to seek needed special assistance in obtaining health care services, such as transportation.

For imaging specifically, they may be unable to use the equipment; it may be physically difficult to get into or be put into an MRI or CT machine, or access a mammography machine. Because of these additional barriers, persons with disabilities may not receive the care they need, may receive inadequate care, or may delay or forego medical attention in an emergency situation. Delay in or not receiving appropriate screening tests such as mammography may lead to delays in diagnosis and treatment and less favorable outcomes.

Data and Methods:

We examine the extent to which presence of a disability explains differences in mammography utilization, while controlling for individual and neighborhood socioeconomic (SES) and racial/ethnic characteristics.

Using Medical Expenditure Panel Survey (MEPS) data for years 1999-2004, we identify disabilities in patients using survey variables such as requiring ADL or physical functioning assistance, the use of assistive devices, blindness, deafness, and physical functioning, work, school, or cognitive limitations, and others. Further, we use evidence of eligibility for Medicare under age 65 as evidence of being determined to be disabled.

For women age 40 and older, we compare the probability of having a mammogram persons with disabilities and persons without. We use logistic regression to evaluate probability of imaging controlling for patient and neighborhood characteristics. Coefficients on the disability variables show which disabilities affect utilization and by how much.

Principal findings: Analysis is underway; no results are available at present.

Conclusions: Analysis is underway; no conclusions are available at present. Our results will assist policy makers and payers in estimating the need for suitable equipment, and in designing effective practice guidelines to ensure equitable utilization for patients with disabilities.