Disparities in Health Care Access and Receipt of Preventive Services by Disability Type: Analysis of the Medical Expenditure Panel Survey

Authors

  • Willi Horner-Johnson Ph.D.,

    Corresponding author
    1. Institute on Development and Disability, Oregon Health and Science University, Portland, OR
    • Address correspondence to Willi Horner-Johnson, Ph.D., Institute on Development & Disability, Oregon Health & Science University, 707 SW Gaines Street, Portland, OR 97239; e-mail: hornerjo@ohsu.edu.

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  • Konrad Dobbertin M.P.H.,

    1. Institute on Development and Disability, Oregon Health and Science University, Portland, OR
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  • Jae Chul Lee Ph.D.,

    1. Rehabilitation Medicine Department, Clinical Research Center, National Institutes of Health, Bethesda, MD
    Current affiliation:
    1. Center for Disabilities Studies, College of Education and Human Development, University of Delaware, Newark, DE
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  • Elena M. Andresen Ph.D.,

    1. Institute on Development and Disability, Oregon Health and Science University, Portland, OR
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  • the Expert Panel on Disability and Health Disparities

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    • The members of the Expert Panel are Glenn T. Fujiura, Ph.D.; Lisa I. Iezzoni, M.D., M.Sc.; Gloria L. Krahn, Ph.D., M.P.H.; and Jana J. Peterson-Besse, M.P.H., Ph.D.

Abstract

Objective

To examine differences in access to health care and receipt of clinical preventive services by type of disability among working-age adults with disabilities.

Data Source

Secondary analysis of Medical Expenditure Panel Survey (MEPS) data from 2002 to 2008.

Study Design

We conducted cross-sectional logistic regression analyses comparing people with different types of disabilities on health insurance status and type; presence of a usual source of health care; delayed or forgone care; and receipt of dental checkups and cancer screening.

Data Collection

We pooled annualized MEPS data files across years. Our analytic sample consisted of adults (18–64 years) with physical, sensory, or cognitive disabilities and nonmissing data for all variables of interest.

Principal Findings

Individuals with hearing impairment had better health care access and receipt than people with other disability types. People with multiple types of limitations were especially likely to have health care access problems and unmet health care needs.

Conclusions

There are differences in health care access and receipt of preventive care depending on what type of disability people have. More in-depth research is needed to identify specific causes of these disparities and assess interventions to address health care barriers for particular disability groups.

Ancillary