 |
|
Quality Dimensions That Most Concern People With Physical and Sensory Disabilities
Lisa I. Iezzoni, MD, MSc;
Roger B. Davis, ScD;
Jane Soukup, MSc;
Bonnie O'Day, PhD
Arch Intern Med. 2003;163:2085-2092.
Background People with physical and sensory disabilities face important challenges in obtaining high-quality health care. We examined whether persons who are blind or have low vision, who are deaf or hard of hearing, or who have mobility impairments or manual dexterity problems are satisfied with the technical and interpersonal aspects of their care.
Methods By using a 1996 nationally representative survey of 16 403 community-dwelling elderly and disabled Medicare beneficiaries, we identified persons with disabling conditions. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) controlled for demographic characteristics and managed care membership in predicting dissatisfaction with 12 dimensions of care.
Results Of an estimated 33.58 million noninstitutionalized Medicare beneficiaries, 64.1% (an estimated 21.51 million) reported at least 1 potential disability and 29.5% (an estimated 9.89 million) reported more than 1 potential disability. Roughly 98% of people with and without disabilities believed their physicians were competent and well trained. But statistically significantly more people with disabilities reported dissatisfaction with care for 10 of the 12 quality dimensions. Persons reporting any major disability were more likely to be dissatisfied with physicians completely understanding their conditions (AOR, 2.4; 95% CI, 1.9-3.1), physicians completely discussing patients' health problems (AOR, 2.4; 95% CI, 1.9-2.9), physicians answering all patients' questions (AOR, 2.3; 95% CI, 1.7-3.1), and physicians often seeming hurried (AOR, 1.6; 95% CI, 1.4-1.9).
Conclusions Persons with disabilities generally reported positive views of their care, although they were significantly more likely to report poor communication and lack of thorough care. These findings held regardless of the disabling condition. Thoughtful systematic approaches are required to improve communication and to reduce time pressures that might compromise the health care experiences of people with disabilities.
From the Division of General Medicine and Primary Care, the Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, the Charles A. Dana Research Institute, and the Harvard-Thorndike Laboratory, Boston, Mass (Drs Iezzoni and Davis and Ms Soukup); and Cherry Engineering Support Services, Inc, McLean, Va (Dr O'Day). The authors have no relevant financial interest in this article.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Disparities between persons with and without disabilities in their participation rates in mass screening
Park et al.
Eur J Public Health 2009;19:85-90.
ABSTRACT
| FULL TEXT
Hidden in Plain Sight: Medical Visit Companions as a Resource for Vulnerable Older Adults
Wolff and Roter
Arch Intern Med 2008;168:1409-1415.
ABSTRACT
| FULL TEXT
Impact of patient communication problems on the risk of preventable adverse events in acute care settings
Bartlett et al.
CMAJ 2008;178:1555-1562.
ABSTRACT
| FULL TEXT
Disparities in breast cancer treatment and survival for women with disabilities.
McCarthy et al.
ANN INTERN MED 2006;145:637-645.
ABSTRACT
| FULL TEXT
Patients' Global Ratings of Their Health Care Are Not Associated with the Technical Quality of Their Care
Chang et al.
ANN INTERN MED 2006;144:665-672.
ABSTRACT
| FULL TEXT
Improving Health Care Experiences of Persons Who Are Blind or Have Low Vision: Suggestions From Focus Groups
O'Day et al.
American Journal of Medical Quality 2004;19:193-200.
ABSTRACT
Communicating about Health Care: Observations from Persons Who Are Deaf or Hard of Hearing
Iezzoni et al.
ANN INTERN MED 2004;140:356-362.
ABSTRACT
| FULL TEXT
|
