Utilization of Clinical Preventive Services Among Persons with Different Types of Disabilities

Background and Importance

Use of recommended clinical preventive services (CPS) reduces morbidity and mortality from preventable conditions for all populations.  Disparities have been found in utilization of some CPS among people with disabilities, compared to people without disabilities; however considerable variability in type of CPS examined, design, sample, and results impedes understanding of these disparities.  To elucidate, we compared recommended utilization of four CPS among persons with different disability types using data from the Medical Expenditure Panel Survey (MEPS).  The MEPS is a nationally representative dataset widely used in health care research. 

Methods & Results

Using pooled data from the 2004–2010 MEPS, we examined utilization of four CPS (mammogram, Papanicolaou test, dental check-up, and flu vaccine) among five disability types (physical, cognitive, visual, hearing, and multiple) and the non-disabled population.  With regression models based on the Andersen Behavioral Model, we considered individual- and systems-level factors relating to receipt of CPS by disability type. 

 Statistically significant differences in utilization were present in each CPS area, including some higher and some lower rates depending on disability type and CPS.  Underutilization occurred most frequently for dental check-ups, Papanicolaou tests, and mammograms.  Logistic regressions showed that the predictive value of individual and systems-level factors varied widely across disability type.             

Conclusion

Persons with disabilities experience some disparities in CPS use compared to the non-disabled population. Considering type of disability is necessary to determine which factors contribute to receipt and non-receipt of CPS and is similarly advised when designing interventions to improve CPS utilization rates.