Improved detection of patient disabilities can reduce disparities in clinical care

Nearly 20 percent of the U.S. population lives with a disability, but little attention has been paid to improving the quality of healthcare provided to disabled patients. A major factor has been inadequate identification of specific disabilities.

"People with disabilities are a diverse population and it is difficult to fully capture their experiences within the healthcare system," said lead author Megan A. Morris, Center for Healthcare Studies at Northwestern University, Chicago. "After passage of the Affordable Care Act, the Department of Health and Human Services published six required disability status questions, but they fulfill agency needs and are not designed to gather disability data within a healthcare provider organization."

According to Morris, the ACS questions may be limited because they focus on impairments and limitations and do not includ environmental and personal factors. For example, patients with communication or learning disabilities are important to identify because they may have difficulty in communicating with physicians or with overall health literacy.

The study recommended that healthcare providers develop questions that capture the range of possible disabilities and produce actionable data, which can be used for developing quality improvement initiatives. Also, the authors suggested that involving persons with disabilities and their families in developing questions would help incorporate a broader perspective in which environmental and social factors are considered. This will help identify potential disparities. The authors concluded that pinpointing disparities in care for disabled patients would enable provider organizations to establish effective quality improvement initiatives and eliminate disability disparities.