Impact of Mental Health/Cognitive Disability Upon Healthcare Utilization: Perspectives from Patients and Healthcare Providers

Background: The US Census estimates nearly 54.4 million people have some type of disability. Persons with disabilities often face undue barriers in accessing health services and medical treatment. This study evaluated the perceptions of barriers to healthcare access between persons with disabilities and healthcare providers.

Methods: Retrospective study of 540 persons with disabilities receiving Medicaid benefits enrolled in an HMO. And, healthcare providers providing care to the general population (n=325) grouped into five categories: outpatient mental health, inpatient mental health, outpatient medical, inpatient medical, and dentists.

Results: Persons with mental health and cognitive disabilities had higher odds of utilizing outpatient mental health, dentists, and inpatient mental health services. Persons with cognitive limitations experienced barriers related to need (OR 2.16, p 0 0.001) and understanding (OR 3.40 p 0.001) when accessing outpatient medical care, and barriers related to need (OR 3.23 p 0.018) when accessing dental care. Providers indicated daily care for persons with mobility (50.1%), mental illness (57.8%), or cognitive limitations (48.2%). Dentists (OR 4.00, p 0.0012) and outpatient mental health/substance abuse providers (OR 2.52, p 0.0102) were more likely to perceive inadequate insurance coverage compared to outpatient medical providers.

Conclusions: The perception gap between healthcare providers and persons with mental health or cognitive disabilities highlights the importance of addressing the specific needs of persons with different types of disabling conditions rather than assuming that all persons with disabilities face the same challenges in accessing healthcare.