ACRM Excellence in Health Equity Research Award: Barriers People with Disabilities Experience When Accessing Health Care 5794

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.

Disclosures

none.