Medical care utilization among U.S. adults with disabilities

Objective: We investigated medical care utilization of U.S. adults with different types of disability (comorbid physical and mental disabilities, physical disability, mental disability and no disability). Methods: Self-reported hospitalizations, hospitalized days, and emergency room [ER] visits in the previous 12 months were classified into three categories: 0, 1-2, and 3+, and compared among 34,653 adults who participated in the National Epidemiologic Survey on Alcohol and Related Conditions Wave II. Multivariable ordinal logistic regression analyses were conducted to estimate adjusted odds ratios (AOR) and predicted adjusted risk ratios (ARR) of medical care utilization by different types of disability, controlling for demographic and socioeconomic factors. Results: The weighted prevalences of comorbid physical and mental disabilities, physical disability, and mental disability are 1.1%, 7.5%, and 3.2%, respectively. When compared to persons without disability, the AORs for hospitalizations, hospitalized days and ER visits had similar patterns in multivariable models: persons with comorbid physical and mental disabilities had highest AORs (4.02-4.92), followed by persons with physical disability (3.10-4.03) and persons with mental disability (2.34-2.45, all p<0.001). ARRs for 3+ hospitalizations were 4.68, 3.83, 2.40 for persons with comorbid physical and mental disability, physical disability, and mental disability, respectively when compared to those without disability (all p<0.001). Similar trends were observed for hospitalized days and ER visits. Conclusions: All three types of medical care utilization were reported more often among persons with disabilities than persons without disability.