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An estimated 15 percent of the U.S. population has some activity limitation, and nearly 5 percent of these individuals are unable to work or carry out other major activities. These people with disabilities (PWDs) are more likely to be older, black, Native American, or to live in rural areas. The Agency for Healthcare Research and Quality supports studies to improve the healthcare of disabled people through the agency's Office of Priority Populations Research.
In a recent article written to provide a context for a series of papers commissioned by AHRQ and published in the Milbank Quarterly, Carolyn M. Clancy, M.D., Acting Director of AHRQ, and Elena M. Andresen, Dr.P.H., of Saint Louis University, describe the Agency's agenda for disability-related health services research.
Agency-supported studies to improve the health of PWDs could include a focus on disability-relevant outcomes such as independence. Many current research projects on specific clinical conditions could be expanded to important areas of disability, such as which financial and organizational characteristics support the provision of patient-centered care, which is particularly important for PWDs. Concerns of people with disabilities about poorly coordinated services across settings and providers are not very different from those of people with specific chronic conditions, note Drs. Clancy and Andresen. They also note the potential for adding disability supplements to national surveys of health care costs and use and including PWDs in priority research areas such as patient safety.
They identify opportunities for PWD-specific health services research, such as studies that determine medical necessity and insurance coverage for PWDs. Such studies might address the basis for insurance coverage, when the evidence is limited, for things such as durable medical equipment and selective rehabilitative services. They also observed the paucity of studies on support for caregivers; intersection of health and supportive social services; the effects of multiple factors associated with vulnerability, such as race and disability; use of restorative technologies; effectiveness of various rehabilitative services; and discrimination by health care providers.
Details are in "Meeting the health care needs of persons with disabilities," by Drs. Clancy and Andresen, in the Milbank Quarterly 80(2), pp. 381-391, 2002.
Reprints (AHRQ Publication No. 02-R084) are available from the AHRQ Publications Clearinghouse.
Editor's Note: The following papers were commissioned by AHRQ and appear in the same issue of the Milbank Quarterly:
- DeJong, G, Palsbo, S.E., Beatty, P.W., and others. "The organization and financing of health services for persons with disabilities," pp. 261-301.
- Perrin, J.M. "Health services research for children with disabilities," pp. 303-324.
- Jette, A.M., and Keysor, J.J. "Uses of evidence in disability outcomes and effectiveness research," pp. 325-345.
- Iezzoni, L.I. "Using administrative data to study persons with disabilities," pp. 347-379.
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