Disparities in utilization of clinical preventive services among people with disabilities: A systematic scoping review

Background: Examinations of clinical preventive service (CPS) utilization by people with disabilities are represented in the literature, but less attention is given to CPS disparities among subgroups of people with disabilities. The present study systematically examined peer-reviewed literature for data showing disparities in the utilization of CPS among subgroups of people with disabilities.

Methods: A functional definition of disability was used that included physical, sensory, cognitive, mental health, social, or activity limitations. Using systematic scoping review methodology, electronic and table of contents literature searches were conducted for years 2000 – 2009. Identified abstracts were reviewed according to inclusion/exclusion criteria. Full-text articles of included abstracts were then reviewed. For articles meeting all criteria, data extraction was performed independently by two reviewers. Inter-coder reliability was monitored regularly.

Results: Search methods yielded 3162 articles for review. Eighteen articles met all inclusion criteria and were included for subsequent data extraction. Results of preliminary analysis indicate that articles include samples with physical disability only, mental health disability only, and cross-disability samples that often compare disability types. CPS practices examined frequently are physical exam, immunizations, cholesterol and blood pressure screening, mammography, and cervical cancer screening. Disparity factors examined frequently are disability type/diagnosis, disability severity, and age. Further findings to be reported will illustrate where significant CPS utilization disparities among people with disabilities exist, and areas where additional research is needed.

Conclusions: Available research indicates some disparity trends, but additional research is needed to fully determine which subgroups of people with disabilities experience disparities in CPS utilization.