Health Care Access Intervention Study

The purpose of this study was to develop and test methods for improving access to routine health care for people living with disabilities.

Methods

We designed and piloted a multi-phase clinic intervention to:

  1. improve clinician and staff awareness of general challenges faced by adults with physical disabilities in the primary care setting;
  2. facilitate a tailored process through which the clinic reflects on and identifies areas for improvement in the provision of preventive services for their patients with mobility impairments; and
  3. facilitate the formation and execution of a clinic-specific plan to address identified areas for improvement. The intervention was based on the principles of participatory research and the facilitated clinic change model.  We implemented the intervention at two rural primary care clinics, and included 316 patients and 26 clinicians and clinic staff members in the study.

Results

As a result of the intervention:

  • Clinicians and clinic staff members reported an improved understanding and awareness of issues facing adults with disabilities in primary care.
  • Clinicians and clinic staff members reported that the intervention was useful for identifying and addressing areas for improvement in their clinic’s provision of preventive services for adult patients with physical disabilities.
  • Clinic members at both sites identified numerous “quick fixes” that addressed identified barriers to care for their patients with physical disabilities.
  • Many of the changes that were identified were subsequently planned and implemented, often within days after the initial meeting.

We learned that tailoring the delivery of the elements of the intervention to the needs of individual clinics led to participation by more staff members.

In developing a patient registry for a clinic’s self-identified quality improvement project, we incidentally recognized a discrepancy between patients’ self-report of disability and clinic members’ perceptions that a patient might be at risk of not receiving clinical preventive services.

Further Reading About New Measure

Clinic Process Changes to Improve Preventive Services for Adults with Mobility Impairments - Read the Brief from our 2008 State of the Science Conference Proceedings.

Journal Articles

Buckley DI, Davis MM, Andresen EM. Does a standard measure of self-reported physical disability correlate with clinician perception of impairment related to cancer screening? Cancer 2012;118(5):1345-1352.