Senczyszyn A, Duncan J.C. HEALTH CARE ACCESSIBILITY FOR INDIVIDUALS WITH DISABILITIES: BARRIERS AND RISK FACTORS IMPACTING CARE. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, POSTER PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32046 1 OPEN ACCESS AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 ABSTRACT (POSTER PRESENTATION) HEALTH CARE ACCESSIBILITY FOR INDIVIDUALS WITH DISABILITIES: BARRIERS AND RISK FACTORS IMPACTING CARE Abbey Senczyszyn*, J. Chad Duncan Northwestern University Prosthetics-Orthotics Center, USA. *Email: abbey.senczyszyn@northwestern.edu DOI: https://doi.org/10.33137/cpoj.v1i2.32046 BACKGROUND Healthcare professionals have certain professional, legal, and ethical obligations that they must fulfill with each patient interaction. Though professional and legal obligations may vary between fields of practice, the core ethical responsibility remains the same: provide just health care1. This requires that healthcare professionals are aware of systemic and institutional factors that lead to disparity and discrimination in the provision of health services1. Disability is a complex construct that can be related to various factors related to health condition as well as social and environmental factors that influence participation. This complexity results in varying definitions; the ICF model of disability was used in this research2. Figure 1. ICF Framework2 METHODS Inclusion Criteria: • Health care in the United States • Individuals with a physical disability or limitation • Discussion of disparity and accessibility related to the provision of healthcare • Publication date of January 1, 2014 or later • Data from 2010 or later • Age 18 and older Exclusion Criteria: • Studies irrelevant to health care in the United States • Individuals with a mental disability or hard of hearing • Specialty care irrelevant to the purposes of this study • Pediatric patient population • Full text not available. https://doi.org/10.33137/cpoj.v1i2.32046 Senczyszyn A, Duncan J.C. HEALTH CARE ACCESSIBILITY FOR INDIVIDUALS WITH DISABILITIES: BARRIERS AND RISK FACTORS IMPACTING CARE. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, POSTER PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32046 2 OPEN ACCESS AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 ABSTRACT (POSTER PRESENTATION) PRELIMINARY RESULTS: ACCESS BARRIERS Figure 2. Commonly cited barriers preventing access to healthcare evaluated in current literature3,5-8,10-12,15,20-21 PRELIMINARY RESULTS: RISK FACTORS Figure 3. Commonly cited risk factors potentially resulting in healthcare disparity evaluated in current literature3-5, 8-11,13-14,16- 22. LIMITATION • Non-homogenous populations • Varying data sources. DISCUSSION Disparity in the provision of health care is not a new topic of discussion; however, past research has primarily focused on age, racial/ethnic, and socioeconomic disparities related to health care. Recently, arguments have been made that people with disability also experience disparity in the receipt of health care services. This research sought to compile the most commonly cited factors that are thought to factor into this inequality. Despite the implementation of various legislative measures including the Americans with Disability Act and, more recently, the Patient Protection and Affordable Care Act, disparity still exists in the provision of health care. The most commonly cited barriers include transportation5,7,9-11,14,19-20, care coordination4-5,9-11,14, and physical access to a health care provider7,10-11,14,19-20. Certain groups are more likely to experience these barriers to care, the most commonly cited significant factors being age9-10,13,15-16,19,21, race/ethnicity9,12-13,15-21, and gender10,15,18-19. REFERENCES 1. American Society for Bioethics and Humanities. (2011). Core Competencies for Healthcare Ethics Consultation (2nd ed.). Glenview, IL: Author. 2. World Health Organization. International Classification of Functioning, Disability, and Health. Geneva, Switzerland: World Health Organization; 2001. 3. Gulley SP, Rasch EK, Chan L. Difference, disparity, and disability: a comparison of health, insurance coverage, and health service use on the basis of race/ethnicity among US adults with disabilities, 2006-2008. Medical care. 2014;52(10 Suppl 3):S9-16. DOI:10.1097/MLR.0000000000000129 4. Bogner et al. Patient Satisfaction and Perceived Quality of Care Among Older Adults According to Activity Limitation Stages. Archives of physical medicine and rehabilitation. 2015;96(10):1810-9. DOI:10.1016/j.apmr.2015.06.005 5. Hall JP, Kurth NK, Chapman SL, Shireman TI. Medicaid managed care: issues for beneficiaries with disabilities. Disability and health journal. 2015;8(1):130-5. DOI: 10.1016/j.dhjo.2014.08.010 6. Kennedy J, Wood EG, Frieden L. Disparities in Insurance Coverage, Health Services Use, and Access Following Implementation of the Affordable Care Act: A Comparison of Disabled and Nondisabled Working-Age Adults. 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CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, POSTER PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32046 3 OPEN ACCESS AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 ABSTRACT (POSTER PRESENTATION) 9. McClintock HF, Kurichi JE, Kwong PL, Xie D, Streim JE, Pezzin LE, et al. Disability Stages and Trouble Getting Needed Health Care Among Medicare Beneficiaries. American journal of physical medicine & rehabilitation. 2017;96(6):408-16. DOI:10.1097/PHM.0000000000000638 10. Pezzin LE, Bogner HR, Kurichi JE, Kwong PL, Streim JE, Xie D, et al. Preventable hospitalizations, barriers to care, and disability. Medicine. 2018;97(19):e0691. DOI: 10.1097/MD.0000000000010691 11. Bauer SE, Schumacher JR, Hall A, Marlow NM, Friedel C, Scheer D, et al. 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Subgroup differences in having a usual source of health care among working-age adults with and without disabilities. Disability and health journal. 2015;8(2):296-302. DOI: 10.1016/j.dhjo.2014.08.012 16. Gimm G, Blodgett E, Zanwar P. Examining access to care for younger vs. older dual-eligible adults living in the community. Disability and health journal. 2016;9(3):431-8. DOI:10.1016/j.dhjo.2015.12.004 17. Horner-Johnson W, Dobbertin K. Usual source of care and unmet health care needs: interaction of disability with race and ethnicity. Medical care. 2014;52(10 Suppl 3):S40-50. DOI:10.1097/MLR.0000000000000193 18. Mahmoudi E, Meade MA. Disparities in access to health care among adults with physical disabilities: Analysis of a representative national sample for a ten-year period. Disability and health journal. 2015;8(2):182-90. DOI: 10.1016/j.dhjo.2014.08.007 19. Ryan J, Abrams MK, Doty MM, Shah T, Schneider EC. How High-Need Patients Experience Health Care in the United States. Findings from the 2016 Commonwealth Fund Survey of High-Need Patients. Issue brief (Commonwealth Fund). 2016;43:1-20. 20. Stillman MD, Frost KL, Smalley C, Bertocci G, Williams S. Health care utilization and barriers experienced by individuals with spinal cord injury. Archives of physical medicine and rehabilitation. 2014;95(6):1114-26. DOI:10.1016/j.apmr.2014.02.005 21. Torres H, Poorman E, Tadepalli U, et al. Coverage and access for Americans with chronic disease under the Affordable Care Act. Ann Intern Med. 2017; 166(7):472-479. DOI:10.7326/M16-1256 ACKNOWLEDGEMENTS & DISCLOSURE I would like to thank Dr. J. Chad Duncan for his help during this project: providing guidance and feedback during the development of this research. This research was developed as part of the NUPOC curriculum. No funding sources or sponsorships were provided during the completion of this research. https://doi.org/10.1097/PHM.0000000000000638 https://doi.org/10.1097/MD.0000000000010691 https://doi.org/10.1016/j.dhjo.2016.03.001 https://doi.org/10.1177/0164027516681165 https://doi.org/10.1016/j.dhjo.2016.01.001 https://doi.org/10.1016/j.dhjo.2015.08.007 https://doi.org/10.1016/j.dhjo.2014.08.012 https://doi.org/10.1016/j.dhjo.2015.12.004 https://doi.org/10.1097/MLR.0000000000000193 https://doi.org/10.1016/j.dhjo.2014.08.007 https://doi.org/10.1016/j.apmr.2014.02.005 https://doi.org/10.7326/M16-1256