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Access to Health Care Services for Persons with Disabilities: Defining the Barriers to Successful Strategies for Change

This project is funded by the National Institute on Disability and Rehabilitation Research, and seeks to examine barriers to the continuum of health care services for individuals with disabilities across the lifespan in Massachusetts. For the purposes of this research, we use four broad categories of functional limitations as a framework for examining environmental barriers: mobility, communication, cognitive and medical.

The study targets both consumers with disabilities and health care providers offering services to these consumers.

1. There are differences among provider types along the health care continuum regarding physical accessibility for people with disabilities
   
2. All health care providers are more aware of and more likely to have addressed physical accessibility than cognitive, communication or medical accessibility
   
3. There are differences between providers and consumers in their perceptions of access barriers

To test these hypotheses, we have undertaken 6 major tasks:

1. Conducting consumer focus groups about access to health care to provide input into the provider survey and to deepen our understanding of barriers to health care.
   
2. Surveying people with disabilities about their access to health care.
   
3. Surveying providers of primary, acute and long-term care services in medicine, dental, substance abuse, and mental health about access to health care.
4. Visiting providers whose survey responses indicate that they demonstrate best practices with respect to access to health services for people with disabilities and develop case studies about their activities.
5. Developing recommendations about improving access to health services for people with disabilities, and a future basic and applied research agenda.
6. Working closely with an Advisory Group of consumers, providers and other individuals involved in planning for the delivery of health care services for people with disabilities.
   
   

We will also develop dissemination projects that will advance knowledge and practice among purchasers, regulators, health plans, health care providers, and individuals with disabilities. This project will also allow us to develop a research agenda for future activities in this area.

At present, the first and second activities have been completed. The consumer survey has been administered to over 1100 individuals with a wide range of disabilities, in both English and Spanish, to consumers with disabilities. These results are currently being entered into an SPSS database for analysis. The third task, surveying providers of services, is currently underway. The surveys were disseminated in February 2001 and are scheduled for entry into a database for analysis in May 2001.

A third committee meeting is currently being planned to present preliminary findings from the consumer and provider surveys.

Key staff for this project:

• Mari-Lynn Drainoni, PhD, Principal Investigator
• Carol Tobias, MMHS, Co-Investigator
• Sara Bachman, Ph.D. Boston University School of Social Work, Co-Investigator
• Jennifer Andrew, MPH, Project Coordinator
• Jocelyn McCree, MA, Program Manager
• Viviana Abuchar, MSW, Program Manager
• Mark Vedrani, BS, Research Assistant
• Bethlyn Vergo, MSW, Research Assistant
• Spenser Weppler, BA, Research Assistant