Disability
Policy and Services
Beth Israel Deaconess Medical Center
Quality of Care and Service Use
for People with Disabilities
CESSI explored barriers
to primary care for people with disabilities. People
with disabilities are especially vulnerable to adverse
experiences with the health care delivery system. Many
factors may compromise their care, including short
times available to address complex issues with clinicians,
sensory and cognitive communication barriers, limited
financial resources, and physically inaccessible care
sites. The primary product of this study was policy
recommendations and educational strategies for improving
the quality of care for persons with disabilities,
targeting areas where care currently may be compromised.
CESSI used both quantitative and qualitative
approaches, while analyzing data from the 1994 and
1995 National Health Interview Survey Disability Supplement
(NHIS-D), merged with information from the Family Resources
and Healthy People 2000 supplements; Medical Expenditure
Panel Survey (MEPS); and Medicare Current Beneficiary
Survey (MCBS), including information from Medicare
claims.
These analyses compared quality of care and service
use for people with and without disabilities.
CESSI also obtained
direct, experiential insight into potential causes
for identified problems and possible solutions, we
conducted: interviews of persons with different types
of disabilities; interviews with primary care and specialist
physicians; and site visits to physicians’ clinics
and offices. Additional interviews with key informants,
representing advocates for persons with disabilities,
physician organizations, and experts in measuring and
improving quality of care, guided the analysis and
development of policy recommendations.
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