Predicting Barriers to Primary Care for Patients with Disabilities: A Mixed Methods Study of Practice Administrators

Document Type

Article

Publication Date

4-2013

Publication Title

Disability and Health Journal

Volume

6

Issue

2

First page number:

116

Last page number:

123

Abstract

BACKGROUND:

People with disabilities continue to be identified as a group who experience disparate health/health care. They are less likely to engage in some health care services. Structural barriers are often identified as one of the reasons for the underutilization of some health care services by people with disabilities. However, to date no study has been conducted to understand why structural barriers persist twenty years after the Americans with Disabilities Act (ADA) became law.

OBJECTIVES:

We examined the relationship between primary care practice administrators' knowledge of the ADA and the number of accessibility barriers that patients with mobility disabilities might encounter.

METHODS:

Primary care practice administrators who were members of a medical management organization were surveyed between December 20, 2011, and January 17, 2012. A mixed methods research design was employed. Data were analyzed using a Guttman scale, linear and multiple linear regression.

RESULTS:

ADA knowledge questions conformed to a valid Guttman scale. There was a significant inverse relationship between practice administrators' knowledge of the ADA and the number of barriers reported in their clinics. Age of the administrators and buildings built before 1993 were also significant predictors of the number of barriers.

CONCLUSION:

This study helps to identify medical practices that are more likely to have access barriers and have the greatest need for ADA compliance interventions. Results from this study highlight practice administrators' need for specific knowledge of the ADA as it applies to their medical practice. Efforts are needed to improve disability training for health professionals.

Keywords

Ability; Influence of age on; Administrative personnel; Adult; Age factors; Americans with Disabilities Act of 1990 (United States); Disabled Persons/Legislation & Jurisprudence; Environment design; Female; Health care surveys; Health services accessibility; Health services accessibility--Law and legislation; Health Services Accessibility/Legislation & Jurisprudence; Health Services Needs and Demand; Healthcare Disparities/Legislation & Jurisprudence; Humans; Law; Linear models; Linear models (Statistics); Male; Medical care surveys; Men; Middle aged; Middle-aged persons; Older people; People with disabilities; Primary health care; Primary Health Care/Legislation & Jurisprudence; Professional competence; Public health; United States; Women

Disciplines

Community-Based Research | Disability Law | Health Policy | Inequality and Stratification | Law | Public Health | Public Policy

Language

English

Permissions

Use Find in Your Library, contact the author, or interlibrary loan to garner a copy of the item. Publisher policy does not allow archiving the final published version. If a post-print (author's peer-reviewed manuscript) is allowed and available, or publisher policy changes, the item will be deposited.

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