Access to the spectrum of healthcare services is of primary concern to individuals with disabilities. One goal of this project is to determine whether healthcare coverage type (managed care, fee-for-service) is associated with access to health services among a national sample of people with cerebral palsy (CP), multiple sclerosis (MS), spinal cord injury (SCI) or arthritis. In 1999, we conducted a national mail survey of approximately 900 adults with CP, MS, SCI or arthritis. We measured access to primary care, specialists, medications, assistive equipment, physical rehabilitation, and mental health services by determining need for each service and the extent to which the expressed need was met with receipt of service. Health plan type (managed care / fee-for service) served as the primary independent variable, and disability severity, health status, payer type, age, disability type, and income level served as secondary independent variables. We conducted logistic regression analyses to measure the effects of the independent variables on access to each of the services listed above. Respondents covered by managed care plans were significantly less likely to receive specialty services when needed, though health plan type was not associated with other service delivery areas. Health status and income level were consistent predictors of access to nearly all of the health services examined. Regardless of health plan type, physical rehabilitation was the service need most likely to go unmet. Closer inspection of health plan benefit packages, and of the contexts in which people with disabilities live and seek healthcare services is needed. See www.nrhchdr.org
Learning Objectives: 1) Discuss levels of perceived need for specific health services among people with disabilities, and the extent to which that need is met with service receipt. 2)Identify characteristics of individuals with disabilities, and the health plans covering them, that are associated with access to the spectrum of health care services.
Keywords: Disability, Health Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.