Aging with a LONG-TERM Physical Disability: Primary and Rehabilitation Care Use

Introduction.  People with disabilities and chronic conditions indicate high utilization of many types of health care in numerous settings.  People with long-term physical disabilities (LTPD), such as multiple sclerosis, muscular dystrophy, post-polio syndrome, and spinal cord injury, are living longer than ever.  Now, people with LTPDs’ health may not only experience secondary conditions (pain, fatigue, depression) from their original disability, but aging as well.  In this study we examined the use of primary and rehabilitation care by people aging with LTPD. 

Methods. We identified needs, barriers / facilitators, and predisposing characteristics of primary and rehabilitation care use from a self-reported survey collected in 2012–2013 of community dwelling people aging with LTPD.  We used Anderson’s model of health services utilization as a conceptual model.

Results.  The survey was completed by 1,369 people with LTPD with a mean age of 63 years.  In the last 12 months, 70% reported seeing a primary care provider (PCP) and 65% a rehabilitation provider.  The most common need predicting PCP use was severe mobility limitation and pain interference.  For seeing rehabilitation providers the main predictor, also a need, was all ranges of mobility issues (mild to severe).  Relative to men, women with LTPD were less likely to see a PCP.  Surprisingly, socioeconomic status and health insurance coverage were not predictors of health care usage.

Conclusion.  Needs, overwhelmingly mobility driven, affect use of health services among people with LTPD.  More research is needed to further describe the complex health care usage of people aging with LTPD.