This three-year research project, funded by the National Institute on Disability and Rehabilitation Research (NIDRR), aimed to examine access barriers to the continuum of mainstream health care services for persons with disabilities across the lifespan in Massachusetts. This project was designed to test the following three research hypotheses:
- There are differences among provider types along the health care continuum regarding physical accessibility for persons with disabilities;
- All health care providers are more aware of and more likely to have addressed physical accessibility than cognitive, communication, or medical accessibility;
- There are differences between providers and consumers in their perceptions of access barriers.
To test the hypotheses, we undertook several major activities during the course of the project. These activities included: convening focus groups consisting of individuals with disabilities and their caregivers; development and completion of surveys of two different groups of individuals with disabilities across the lifespan in Massachusetts; development and completion of a survey of a range of health care providers; analysis of the results of both the consumer and provider surveys; periodic presentation of our results to an Advisory Committee comprised of individuals with disabilities, disability advocates, health care providers, and policy makers; and development of several dissemination products targeted to both consumers with disabilities and health care providers.
The results of this study clearly indicate that interventions to address access barriers to care need to consider several factors. First, it is important to obtain information from individuals whose disability and socio-economic status are severe enough to pose significant barriers to care. Population-based studies may not provide this level of insight. Second, barriers to care are somewhat different for children, working-age adults, and elders, and must be addressed with this in mind. Third, barriers to care are very different across provider types. Certain services, such as dental care, mental health services, and substance abuse treatment programs, are far less accessible in every realm than outpatient and inpatient medical services. Finally, the broad spectrum of disability must be considered in addressing barriers to care. While the best of providers have addressed physical access issues, many barriers to care continue to exist for individuals whose disability impacts communication, vision, and hearing.