In their """"""""Consumer Bill of Rights and Responsibilities,"""""""" the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry noted that today's health care consumers report """"""""poor communication with their doctor, feeling rushed or ignored, lack of dignity during examinations, ..., receiving inadequate explanations or advice, [and] having inadequate time with the doctor during routine visits,"""""""" among other complaints. While many consumers share these concerns, persons with disabilities are especially vulnerable to substandard health care. Many factors affect their care - ranging from short times available to address complex issues with clinicians to sensory and cognitive communication barriers to limited financial resources to physically inaccessible care sites. Using both quantitative analyses of existing surveys and qualitative analyses of interviews, our goal is to understand the role of disability in experiencing poor quality care, along various dimensions. We shall focus on access to care, use of primary care and preventive services, and the role of different types of physicians (e.g., specialists versus primary care) in meeting patients' needs. Quality will be examined within categories of disabilities, defined considering both functional and medical aspects of disabling conditions. We shall analyze data from three national surveys: (1) the 1994 and 1995 National Health Interview Survey Disability Supplement, merged with information from the Family Resources and Healthy People 2000 supplements; (2) the Medical Expenditure Panel Survey; and (3) the Medicare Current Beneficiary Survey, including information from Medicare claims. To obtain direct, experiential insight, we shall conduct: interviews of persons with 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 health care, will guide the analysis. Using both the survey results and experiential findings, we shall develop specific recommendations for targeting interventions and improving quality of care for people with disabilities. Given that roughly 49 million Americans have a disabling condition, addressing concerns about their quality of care is essential.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Project (R01)
Project #
5R01HS010223-03
Application #
6391090
Study Section
Health Care Quality and Effectiveness Research (HQER)
Program Officer
Sangl, Judith
Project Start
1999-09-30
Project End
2003-03-29
Budget Start
2001-09-30
Budget End
2003-03-29
Support Year
3
Fiscal Year
2001
Total Cost
Indirect Cost
Name
Beth Israel Deaconess Medical Center
Department
Type
DUNS #
076593722
City
Boston
State
MA
Country
United States
Zip Code
02215
Weil, Evette; Wachterman, Melissa; McCarthy, Ellen P et al. (2002) Obesity among adults with disabling conditions. JAMA 288:1265-8