Accessibility of primary health care provider settings for people with disabilities: Information from health plan audits

This study reports on the accessibility of primary care providers' facilities to patients with disabilities using a unique dataset derived from facility site reviews conducted by four health plans in California. Since 2006, the health plans have conducted accessibility surveys at the same time that they administer the every 3 year state-required Facility Site Review (FSR). Across the four plans information on the accessibility of several thousand primary care practice settings has been collected using a 55-item survey entitled “ADA Seniors and Persons with Disabilities (SPD) Facility Site Review Assessment Tool”. The data are collected by trained nurses who walk through provider buildings and offices to complete the survey. This paper presents our first findings from the analysis of the merged dataset of health plan surveys. The dataset constitutes the largest sample to date of providers' facilities and their access characteristics. Early analyses of the data show that providers have greater internal access (e.g., restrooms and exam rooms) than external building access (e.g. ramps and parking). However, accessible exam tables and weight scales are present in a very small percentage of providers' offices. Because there are no nationally representative surveys of providers' offices nor national figures on the proportion of providers prepared to serve patients with disabilities, this study offers valuable information and insights on the accessibility of the nation's health care system for patients with disabilities, and the magnitude of assistance that would need to be offered to providers to increase the accessibility of their services.