Access Barriers for Persons with Disabilities

Abstract

Individuals with disabilities constitute a marginalized group in health services research, and their experiences within the health-care system are not well understood. This article examines the access barriers to primary, specialist, and rehabilitative care, and their consequences for individuals' health, functioning, well-being, and health services utilization. The findings are based on an in-depth analysis of 30 qualitative interviews. Access problems are grouped into environmental, structural, and process barriers. The findings highlight the complex nature of access barriers for people with disabilities and underscore the importance of disability literacy in the health service delivery process.

Get full access to this article

View all access options for this article.

References

Aday, L. (1975). Economic and noneconomic barriers to the use of needed medical services. Medical Care, 13, 447-456.

Beatty, P.W. , & Dhont, K.R. (2001). Medicare health maintenance organizations and traditional coverage: Perceptions of health care among beneficiaries with disabilities. Archives of Physical Medicine and Rehabilitation , 82, 1009-1017.

Collins, K.S. , Hughes, D.L. , Doty, M.M. , Ives, B.L. , Edwards, J.N. , & Tenney, K. (2002, March). Diverse communities, common concerns: Assessing health care quality for minority Americans. Findings from the Commonwealth Fund 2001 Health Care Quality Survey (Pub No. 523). The Commonwealth Fund.

Davis, M.H. , & O'Brien, E. (1996). Profile of persons with disabilities in Medicare and Medicaid. Health Care Financing Review, 17, 179-211.

Dejong, G. , Beatty, P.W. , Neri, M. , & Hagglund, K. (2001, October). Access to healthcare services among people with disabilities in managed care and fee-for-service health plans. Paper presented at the 129th annual meeting of the American Public Health Association, Atlanta, GA.

Fiscella, K. , Franks, P. , Doescher, M.P. , & Saver B.G. (2002). Disparities in health care by race, ethnicity, and language among the insured. Medical Care, 40(1), 52-59.

Gold, M. , Nelson, L. , Brown, R. , Ciemnecki, A. , Aizer, A. , & Docteur, E. (1997). Disabled Medicare beneficiaries in HMOs. Health Affairs, 16, 149-162.

Lambrew, J.M. , DeFriese, G.H. , Carey, T.S. , Ricketts, T.C. , & Biddle, A.K. (1996). The effects of having a regular doctor on access to primary care. Medical Care, 34, 138-151.

Lishner, D.M. , Richardson, M. , Levine, P. , & Patrick, D. (1996). Access to primary health care among persons with disabilities in rural areas: A summary of the literature. Journal of Rural Health Care, 12(1), 45-53.

10.

Mark, T. , & Mueller, C. (1996). Access to care in HMOs and traditional insurance plans. Health Affairs, 15, 81-87.

11.

National Council on Disability. (2001). National disability policy: A progress report, November 1999-November 2000 . Washington, DC: Author.

12.

Nemet, G.F. , & Bailey, A.J. (2000). Distance and health care utilization among the rural elderly. Social Science and Medicine, 50, 1197-1208.

13.

Park, J. , & Buechner, J.S. (1997). Race, ethnicity, and access to health care, Rhode Island, 1990. Journal of Health & Social Policy, 9(1), 1-14.

14.

Reschovsky, J.D. (1999). Do HMOs make a difference? Access to health care . Inquiry, 36, 390-399.

15.

Sutton, J.P. , & DeJong, G. (1998). Managed care and people with disabilities: Framing the issues. Archives of Physical Medicine and Rehabilitation, 79, 1312-1316.

16.

Weissman, J.S. , Stern, R. , Fielding, S.L. , & Epstein, A.M. (1991). Delayed access to health care: Risk factors, reasons, and consequences. Annals of Internal Medicine, 114, 325-331.

17.

Wholey, D.R. , Burns, L.R. , & Lavizzo-Mourey, R. (1998). Managed care and the delivery of primary care to the elderly and the chronically ill. Health Services Research, 33, 322-353.