Understanding the Connection Between Heavy Health Care Users with and without Disabilities and Timely Receipt of Necessary Care

Research Objective:

In this research we examine the extent to which U.S. working-age (18-64) people with physical limitations, multiple disabilities, or no disabilities reports having had to delay or not receive necessary medical, prescription medicine, and dental care services, and assess whether high-users with disabilities have greater risk of delaying or forgoing necessary care than do high-users without disabilities.

Method:

Those with highest healthcare utilization and highest cost were identified from pooled nationally-representative data from the Medical Expenditure Panel Survey (2004–2010). Analyses included descriptive statistics, bivariate comparisons and logistic regression of delay or forgone receipt of care, by disability type.

Findings:

Compared to high-users without disabilities, high-users with physical or multiple disabilities were older, less educated, poorer, and unmarried. Both disability groups were more likely to have multiple chronic conditions and require ADLs/IADLs assistance. The majority of all groups had health insurance, but the disabilities groups were more likely to have public insurance, only. In multivariate models, individuals with disabilities were significantly more likely than those without disabilities to report delaying or not receiving necessary healthcare.

Conclusions

Our findings emphasize the importance of disability in timely receipt of care. Specifically, even after controlling for sociodemographic characteristics, and health and disability complexity, high-users from two disability subgroups were significantly more likely than high-users without disability to report having delayed or forgone necessary healthcare. The findings highlight the need for research to understand what changeable factors uniquely determine diminished access to necessary care for these disability subgroups, to improve timely receipt of care.