Studies/Analyses
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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