Health care experiences and perceptions among people with and without disabilities

McClintock, Heather F.; Barg, Frances K.; Katz, Sam P.; Stineman, Margaret G.; Krueger, Alice; Colletti, Patrice M.; Boellstorff, Tom; Bogner, Hillary R.

doi:10.1016/j.dhjo.2015.08.007

Cited by 58 publications

(53 citation statements)

References 30 publications

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“…We selected covariates based on our previous findings, 16,17 and grouped them into different categories that include sociodemographics, health conditions, impairments, perceived facilitators to receiving healthcare, perceived barriers to receiving healthcare, and function.…”

Section: Methodsmentioning

confidence: 99%

“…Our primary goal was to create a prediction score system to estimate the risk of functional deterioration, institutionalization, and death within two years among Medicare beneficiaries 65 years of age and older according to their sociodemographics, health conditions or impairments, perceived barriers and facilitators to receiving healthcare, and function compared to those who were stable or improved in function as we were interested in predicting the poor health outcomes. In 5 steps, we estimated a multinomial logistic regression model for stage transition within two years and used that model to create a risk score: (1) identification and categorization of variables based on previous findings 16,17 that were found to be associated with stage transition, (2) assessment of the association of the variables with stage transition in the derivation cohort using chi-square tests, (3) estimation of a parsimonious model in the derivation cohort; (4) development of a point-scoring system in the derivation cohort; and (5) validation of both the model and point system in the validation cohort. 19 …”

Section: Methodsmentioning

confidence: 99%

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Predictive Indices for Functional Improvement and Deterioration, Institutionalization, and Death Among Elderly Medicare Beneficiaries

Kurichi

Kwong

Xie

et al. 2017

PM&R

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Background Prediction models can help clinicians provide the best and most appropriate care to their patients and can help policy makers design services for groups at highest risk of poor outcomes. Objective The objective was to develop prediction models identifying both risk factors and protective factors for functional deterioration, institutionalization, and death. Design Cohort study using data from the Medicare Current Beneficiary Survey (MCBS) Setting Community survey. Participants This study included 21,264 Medicare beneficiaries 65 years of age and older who participated in the MCBS from the 2001–2008 entry panels and were followed for two years. Methods The index was derived in 60% and validated in the remaining 40%. β-coefficients from a multinomial logistic regression model were used to derive points, which were added together to create scores associated with the outcome. Main outcome measure The outcome was activity of daily living (ADL) stage transitions over two years following entry into the MCBS. Beneficiaries were categorized into one of four outcome categories: stable or improved function, functional deterioration, institutionalization, or death. Results Our model identified 16 factors for functional deterioration (age, gender, education, living arrangement, dual eligibility, proxy use, Alzheimer’s disease/dementia, angina pectoris/coronary heart disease, diabetes, emphysema/asthma/chronic obstructive pulmonary disease, mental/psychiatric disorder, Parkinson’s disease, stroke/brain hemorrhage, hearing impairment, vision impairment, and baseline ADL stage) after backward selection (p<.05). Compared to stable or improved function, the risk of functional deterioration ranged from ≤1 to ≥6, ≤4 to ≥22 for the risk of institutionalization, and ≤3 to ≥16 for the risk of death. Conclusion Predictive indices, or point and scoring systems used to predict outcomes, can identify elderly Medicare beneficiaries at risk of functional deterioration, institutionalization, and death and can aid policy makers, clinicians, and family members in improving care for older adults and supporting successful aging in the community.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Predictive Indices for Functional Improvement and Deterioration, Institutionalization, and Death Among Elderly Medicare Beneficiaries

Kurichi

Kwong

Xie

et al. 2017

PM&R

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“…In a qualitative study by deVries‐McClintock et al. (), disabled individuals perceived that their providers were annoyed because of their multiple health issues. These perceptions were reinforced by brief appointment times, rushed patient visits, and lack of coordinated care.…”

Section: Synthesis Of the Literaturementioning

confidence: 99%

Obstacles to preventive care for individuals with disability

Marrocco

Krouse

2017

Journal of the American Association of Nurse Practitioners

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Background and purpose Individuals with disabilities have been identified as a population with a significantly lower usage of preventive services. Nurse practitioners (NPs) provide a key access point in the healthcare delivery system for preventive services for vulnerable populations such as those with disabilities. It is essential to understand existing barriers that prohibit access to effective preventive care for this vulnerable population. Methods Systematic search and review of Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, PubMed, Google Scholar, and government reports and World Health Organizations reports. Twenty‐six articles were included in the review. Conclusions This literature review confirmed previous notions that people with disabilities are receiving much fewer preventive services than the general population. The studies reviewed identified four major barriers that contributed to the lack of preventive care. These barriers included physical environment and system, transportation, provider knowledge and attitude, and financial. Recognition of the obstacles that this subpopulation faces in accessing preventive care services is the first step to effectively remedying this problem. Implications for practice Preventive services have been identified as one of the cornerstones to improving health and quality of life. By understanding the circumstances that restrict those with disabilities from accessing preventive services, NPs can provide meaningful and effective solutions.

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“…13 Lack of knowledgeable health care providers, ineffective communication among providers and with the patient, and inaccessible facilities and equipment are common barriers that are faced when accessing health care services in the community. 14,15 Given this, it is not surprising that individuals with SCI generally prefer receiving services from SCI outpatient services than in the community, 1 as these facilities are better equipped and have the capacity to address many of their health issues.…”

Section: -12mentioning

confidence: 99%

Developing a Model of Care for Healing Pressure Ulcers With Electrical Stimulation Therapy for Persons With Spinal Cord Injury

Lala

Houghton

Kras‐Dupuis

et al. 2016

Topics in Spinal Cord Injury Rehabilitation

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Background: Electrical stimulation therapy (EST) has been shown to be an effective therapy for managing pressure ulcers in individuals with spinal cord injury (SCI). However, there is a lack of uptake of this therapy, and it is often not considered as a first-line treatment, particularly in the community. Objective: To develop a pressure ulcer model of care that is adapted to the local context by understanding the perceived barriers and facilitators to implementing EST, and to describe key initial phases of the implementation process. Method: Guided by the Knowledge-to-Action (KTA) and National Implementation Research Network (NIRN) frameworks, a community-based participatory research (CBPR) approach was used to complete key initial implementation processes including (a) defining the practice, (b) identifying the barriers and facilitators to EST implementation and organizing them into implementation drivers, and (c) developing a model of care that is adapted to the local environment. Results: A model of care for healing pressure ulcers with EST was developed for the local environment while taking into account key implementation barriers including lack of interdisciplinary collaboration and communication amongst providers between and across settings, inadequate training and education, and lack of resources, such as funding, time, and staff. Conclusions: Using established implementation science frameworks with structured planning and engaging local stakeholders are important exploratory steps to achieve a successful sustainable best practice implementation project.

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Health care experiences and perceptions among people with and without disabilities

Cited by 58 publications

References 30 publications

Predictive Indices for Functional Improvement and Deterioration, Institutionalization, and Death Among Elderly Medicare Beneficiaries

Predictive Indices for Functional Improvement and Deterioration, Institutionalization, and Death Among Elderly Medicare Beneficiaries

Obstacles to preventive care for individuals with disability

Developing a Model of Care for Healing Pressure Ulcers With Electrical Stimulation Therapy for Persons With Spinal Cord Injury

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