{"title":"ACRM Excellence in Health Equity Research Award: Barriers People with Disabilities Experience When Accessing Health Care 5794","authors":"Jessica Jarvis, Amy Houtrow","doi":"10.1016/j.apmr.2025.01.025","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>To characterize access to health care experiences reported by people with disabilities living in the United States since 2014.</div></div><div><h3>Design</h3><div>We conducted a systematic review of research published since 2014 and also interviewed people with disabilities living in Pittsburgh, Pennsylvania.</div></div><div><h3>Setting</h3><div>Not applicable.</div></div><div><h3>Participants</h3><div>Twenty-one individuals living in or near Pittsburgh, Pennsylvania that are disabled and/or care for someone who is disabled.</div></div><div><h3>Interventions</h3><div>Systematic literature review and interviews.</div></div><div><h3>Main Outcome Measures</h3><div>The screening protocol identified a total of 5007 articles. Eighty-three articles met inclusion criteria and were included. Articles were of varying quality of reporting, but none were excluded based on their score. Twenty-six percent (26%) (n=22) of the articles captured data from individuals with developmental disabilities, 17% (n=14) with a physical disability, 16% (n=13) from those with mental illness, 16% (n=13) did not restrict any disability type, 13% (n=11) with a sensory disability, 10% (n=8) collected data from multiple types, and only 2% (n=2) were from those with cognitive disabilities. Most studies (n=45, 54%) did not focus on a specific aspect of health care but looked broadly at the system. Dental (n=8) and primary care (n=6) were the next most common services examined.</div></div><div><h3>Results</h3><div>There are multiple themes identified from across the access to health care factors: approachability, availability/accommodations, affordability, acceptability, and appropriateness of health care services. Additionally, we identified the following themes on how access to care impacts people with disabilities: unmet needs, delayed care, negative impact on well-being, and fractured trust in the health care system.</div></div><div><h3>Conclusions</h3><div>Findings confirm that access to health care is limited and unjust for people with disabilities and that limited access does widespread harm. Notably, beyond the very real and direct harms caused to an individual's health by inadequate health care, when accessing care is difficult, it increases experiences of stress and depression, drains individual and societal resources, and negatively impacts relationships, careers, and other necessary components of life.</div><div>This resulted from work supported by the FISA Foundation.</div></div><div><h3>Disclosures</h3><div>none.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e10"},"PeriodicalIF":3.6000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0003999325000516","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives
To characterize access to health care experiences reported by people with disabilities living in the United States since 2014.
Design
We conducted a systematic review of research published since 2014 and also interviewed people with disabilities living in Pittsburgh, Pennsylvania.
Setting
Not applicable.
Participants
Twenty-one individuals living in or near Pittsburgh, Pennsylvania that are disabled and/or care for someone who is disabled.
Interventions
Systematic literature review and interviews.
Main Outcome Measures
The screening protocol identified a total of 5007 articles. Eighty-three articles met inclusion criteria and were included. Articles were of varying quality of reporting, but none were excluded based on their score. Twenty-six percent (26%) (n=22) of the articles captured data from individuals with developmental disabilities, 17% (n=14) with a physical disability, 16% (n=13) from those with mental illness, 16% (n=13) did not restrict any disability type, 13% (n=11) with a sensory disability, 10% (n=8) collected data from multiple types, and only 2% (n=2) were from those with cognitive disabilities. Most studies (n=45, 54%) did not focus on a specific aspect of health care but looked broadly at the system. Dental (n=8) and primary care (n=6) were the next most common services examined.
Results
There are multiple themes identified from across the access to health care factors: approachability, availability/accommodations, affordability, acceptability, and appropriateness of health care services. Additionally, we identified the following themes on how access to care impacts people with disabilities: unmet needs, delayed care, negative impact on well-being, and fractured trust in the health care system.
Conclusions
Findings confirm that access to health care is limited and unjust for people with disabilities and that limited access does widespread harm. Notably, beyond the very real and direct harms caused to an individual's health by inadequate health care, when accessing care is difficult, it increases experiences of stress and depression, drains individual and societal resources, and negatively impacts relationships, careers, and other necessary components of life.
This resulted from work supported by the FISA Foundation.
期刊介绍:
The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities.
Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.