Perspectives of adults with disabilities on access to health care after the ACA: Qualitative findings.
TL;DR: The ACA was intended to expand access to insurance coverage, not necessarily meet all health care related needs for people with disabilities, but many barriers remain to accessing needed care for this population, regardless of insurance status.
About: This article is published in Disability and Health Journal.The article was published on 2019-07-01 and is currently open access. It has received 15 citations till now. The article focuses on the topics: Health care & Medical prescription.
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TL;DR: Examining the intersection of LGBTQ+ identity and ASD reveals compounded health disparities that insurers and medical providers are not adequately addressing, particularly as individuals transition to the adult medical system.
Abstract: We explored the health and health care experiences of people with autism spectrum disorder (ASD) who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ+) using data from a national, internet-based survey of adults with disabilities supplemented by focused interviews. LGBTQ+ respondents had significantly higher rates of mental illness, poor physical health days per month, and smoking compared to straight, cisgender respondents with ASD. LGBTQ+ respondents also reported much higher rates of unmet health care need, inadequate insurance provider networks, and rates of being refused services by a medical provider. Examining the intersection of LGBTQ+ identity and ASD reveals compounded health disparities that insurers and medical providers are not adequately addressing, particularly as individuals transition to the adult medical system.
41 citations
TL;DR: The results of this study provide additional support for a comprehensive examination of both the national standards for accessible health care and the enforcement of laws that prohibit discrimination on the basis of disability.
13 citations
01 Sep 2019
TL;DR: This article uses recent survey data to compare and contrast American adults with intellectual disability and/or autism spectrum disorder and those with other disabilities with regard to overall health, access to health care, and other aspects of community participation.
Abstract: This article uses recent survey data to compare and contrast American adults with intellectual disability (ID) and/or autism spectrum disorder (ASD) and those with other disabilities with ...
11 citations
TL;DR: The gain in insurance coverage for workers with disabilities is an important benefit of the ACA, but more investigation and monitoring should be considered to understand whether such coverage will translate into improvements in access to needed health care.
7 citations
TL;DR: Interactions with the healthcare system during their experience of violence are described as a missed opportunity for identifying and responding to their abuse and connecting them with resources.
Abstract: Women with disabilities are at risk of experiencing multiple forms of severe and prolonged violence, yet guidelines for screening this population are unclear, screening rates are historically low, and screening tools may be inadequate to capture disability-related aspects of abuse. We conducted qualitative in-depth interviews with 33 rural women in the United States with diverse disabilities and experiences of violence. They described overarching healthcare provider and system factors that influenced their trust and confidence in healthcare delivery as an avenue to support their safety. Women described interactions with the healthcare system during their experience of violence as a missed opportunity for identifying and responding to their abuse and connecting them with resources. We conclude with policy and practice recommendations based on women with disabilities’ perspectives and insights.
6 citations
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TL;DR: The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.
Abstract: Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The major differences among the approaches are coding schemes, origins of codes, and threats to trustworthiness. In conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context. The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.
31,398 citations
TL;DR: The evidence is summarized and it is recommended that observed differences are sufficient to meet the criteria for health disparities: population-level differences in health outcomes that are related to a history of wide-ranging disadvantages, which are avoidable and not primarily caused by the underlying disability.
Abstract: Disability is an emerging field within public health; people with significant disabilities account for more than 12% of the US population. Disparity status for this group would allow federal and state governments to actively work to reduce inequities. We summarize the evidence and recommend that observed differences are sufficient to meet the criteria for health disparities: population-level differences in health outcomes that are related to a history of wide-ranging disadvantages, which are avoidable and not primarily caused by the underlying disability. We recommend future research and policy directions to address health inequities for individuals with disabilities; these include improved access to health care and human services, increased data to support decision-making, strengthened health and human services workforce capacity, explicit inclusion of disability in public health programs, and increased emergency preparedness.
605 citations
05 Dec 2007
TL;DR: In this article, the authors describe a type of qualitative content analysis in which categories are largely derived from the data, applied to the data through close reading, and analyzed solely qualitatively.
Abstract: Content analysis is a family of systematic, rule-guided techniques used to analyze the informational contents of textual data (Mayring, 2000). It is used frequently in nursing research, and is rapidly becoming more prominent in the medical and bioethics literature. There are several types of content analysis including quantitative and qualitative methods all sharing the central feature of systematically categorizing textual data in order to make sense of it (Miles & Huberman, 1994). They differ, however, in the ways they generate categories and apply them to the data, and how they analyze the resulting data. In this chapter, we describe a type of qualitative content analysis in which categories are largely derived from the data, applied to the data through close reading, and analyzed solely qualitatively. The generation and application of categories that we describe can also be used in studies that include quantitative analysis.
403 citations
TL;DR: This qualitative study of 26 people who were deaf or hard of hearing suggests that patients and physicians may have varying views about what it means to be deaf and about effective communication modalities, and identifies consequences of inadequate communication with deaf and hard-of-hearing patients.
Abstract: Persons who are deaf or hard of hearing face considerable barriers to communicating with physicians. As the population ages, physicians will encounter many more persons with hearing limitations. En...
307 citations
01 Jan 2005
TL;DR: The Surgeon General's Call to Action to Improve the Health and Wellness of Persons with Disabilities as discussed by the authors emphasizes the centrality of health to the quality of our lives and places their health squarely among public health issues at the forefront of research, service delivery, financing, training and education and health care policy.
Abstract: This Surgeon General's Call to Action to Improve the Health and Wellness of Persons with Disabilities emphasizes the centrality of health to the quality of our lives. Developed by the Surgeon General in collaboration with the Department's Office on Disability, it describes the particular challenges to health and wellbeing faced by persons of all ages with disabilities. It places their health squarely among the public health issues at the forefront of research, service delivery, financing, training and education and health care policy today. It also builds upon the Nation's efforts to promote wellness and disease prevention in all persons, including those with disabilities, as called for in the President's HealthierUS Initiative.
258 citations