142nd APHA Annual Meeting and Exposition

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Unmet Needs and Health Services Appraisal: The Role of Disability Type and Service Delivery Approach

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Randall Owen, PhD , Department of Disabiltiy and Human Development, University of Illinois at Chicago, Chicago, IL
Anne Bowers , Dept of Disability and Human Development, University of Illinois at Chicago, chicago, IL
Tamar Heller, PhD , Department of Disability and Human Development, University of Illinois at Chicago, Chicago, IL
Background: This study examines unmet needs for and appraisal of health services for people with disabilities in Medicaid receiving managed care (MC) versus fee-for-service (FFS) delivery approaches by disability type.

Methods:  The study uses survey data from 817 individuals receiving Medicaid in a Midwestern state. The disability type splits people into groups by their Medicaid waiver: intellectual/developmental (IDD, 193 respondents), physical (PD, 279), and mental health (MH, 198) disabilities and a group who don’t fit those groups (Other, 143). The delivery approach identifies people as receiving MC or FFS.  The survey measures health care appraisal and total unmet needs. A two-way ANOVA for those two outcomes with disability type and delivery approach as independent variables was followed by regressions including age, gender, race, disability, and delivery approach as independent variables.

Results: Both health appraisal and unmet needs are significantly related to disability group but not with delivery approach. For unmet needs, other (1.59) and PD (2.19) have significantly (p<.05) fewer unmet needs than MH (3.16) and IDD (3.37). However, for health appraisal, only the other group had significantly (p<.05) higher ratings than ID or MH. Results of regression analyses show that unmet needs is negatively related (p>.01) to health appraisal and unmet needs is higher for people with physical and mental health disabilities (p<.01) than for people without those conditions.

Conclusion: Unmet needs are important for health plans (MC or FFS) to address. These results specify for which disability types unmet needs are highest so healthcare providers can address them.

Learning Areas:

Administration, management, leadership
Diversity and culture
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Describe the experiences of people with various disabilities within managed care with regard to unmet needs Describe the experiences of people with various disabilities between managed care and fee-for-service Medicaid with regard to unmet needs Identify common unmet needs for people with disabilities

Keyword(s): Disabilities, Managed Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the co-Investigator on 3 research projects of 3 NIDRR RRTCs relating to people with disabilities and managed care. My research interests include healthcare and employment policies for people with disabilities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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