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Access to Preventive Services for Working-Age Adults With Physical Limitations

      Abstract

      Objective

      To examine differences in access to preventive services for working-age adults with physical limitations, nonphysical limitations, and no limitations.

      Design

      Observational data were pooled across calendar years 2003 through 2012 from the Medical Expenditure Panel Survey (MEPS), a nationally representative survey of noninstitutionalized U.S. adults.

      Setting

      Community.

      Participants

      Working-age adults (N=75,145; age range, 18–64y) who responded to all 5 rounds of the MEPS during 2003 through 2012.

      Interventions

      Not applicable.

      Main Outcome Measures

      Blood pressure checks, flu shots, and dental visits, in the last 12 months.

      Results

      Multivariate analyses showed that adults with physical limitations were more likely to receive a blood pressure check (92.2% vs 69.6%, respectively; P<.001) or flu shot (39.7% vs 23.4%, respectively; P<.001) than adults with no limitations. However, those with physical limitations were less likely to have a dental checkup (44.7% vs 59.4%, respectively; P<.001) than those with no limitation. Having a usual source of care increased the odds of receiving preventive services.

      Conclusions

      The study has implications for providers and policymakers. Policies that support the adequacy of provider networks and continuity with a usual source of care may increase the use of preventive services in adults with physical limitations.

      Keyword

      List of abbreviations:

      CI (confidence interval), FPL (federal poverty level), MEPS (Medical Expenditure Panel Survey), OR (odds ratio)
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      References

        • Erickson W.
        • Lee C.
        • von Schrader S.
        2014 Disability Status Report: United States.
        Cornell University, Ithaca, NY2016 (Available at:) (Accessed December 21, 2016)
        • Stevens A.C.
        • Carroll D.D.
        • Courtney-Long E.A.
        • et al.
        Adults with one or more functional disabilities – United States, 2011-2014.
        MMWR Morb Mortal Wkly Rep. 2016; 65: 1021-1025
        • Rasch E.K.
        • Hochberg M.C.
        • Magder L.
        • Magaziner J.
        • Altman B.M.
        Health of community-dwelling adults with mobility limitations in the United States: prevalent health conditions. Part I.
        Arch Phys Med Rehabil. 2008; 89: 210-218
        • Rasch E.K.
        • Magder L.
        • Hochberg M.C.
        • Magaziner J.
        • Altman B.M.
        Health of community-dwelling adults with mobility limitations in the United States: incidence of secondary health conditions. Part II.
        Arch Phys Med Rehabil. 2008; 89: 219-230
        • Barile J.P.
        • Thompson W.W.
        • Zack M.M.
        • Krahn G.L.
        • Horner-Jonson W.
        • Bowen S.E.
        Multiple chronic medical conditions and health-related quality of life in older adults, 2004-2006.
        Prev Chronic Dis. 2013; 10: 1-11
        • Iezzoni L.I.
        Eliminating health and health care disparities among the growing population of people with disabilities.
        Health Aff (Millwood). 2011; 30: 1947-1954
        • Chan L.
        • Beaver S.
        • Maclehouse R.F.
        • Jha A.
        • Maciejewski M.
        • Doctor J.N.
        Disability and health care costs in the Medicare population.
        Arch Phys Med Rehabil. 2002; 83: 1196-1201
        • Rice D.P.
        • LaPlante M.P.
        Medical expenditures for disability and disabling comorbidity.
        Am J Public Health. 1992; 82: 739-741
        • Reichard A.
        • Fox M.H.
        Using population-based data to examine preventive services by disability type among dually eligible (Medicare/Medicaid) adults.
        Disabil Health J. 2013; 6: 75-86
        • Gimm G.
        • Blodgett E.
        • Zanwar P.
        Examining access to care for younger vs. older dual-eligible adults living in the community.
        Disabil Health J. 2016; 9: 431-438
        • Horner-Johnson W.
        • Dobbertin K.
        • Lee J.C.
        • Andresen E.M.
        Expert Panel on Disability and Health Disparities. Disparities in health care access and receipt of preventive services by disability type: analysis of the medical expenditure panel survey.
        Health Serv Res. 2014; 49: 1980-1999
        • Institute of Medicine
        Millman M.L. Access to health care in America. National Academy Press, Washington (DC)1993
        • Meade M.
        • Mahmoudi E.
        • Lee S.
        The intersection of disability and healthcare disparities: a conceptual framework.
        Disabil Rehabil. 2015; 37: 632-641
        • Hoffman J.M.
        • Shumway-Cook A.
        • Yorkston K.M.
        • Ciol M.A.
        • Dudgeon B.J.
        • Chan L.
        Association of mobility limitations with health care satisfaction and use of preventive care: a survey of Medicare beneficiaries.
        Arch Phys Med Rehabil. 2007; 88: 583-588
        • Agency for Healthcare Research and Quality
        Medical Expenditure Panel Survey: survey background.
        (Available at:) (Accessed December 21, 2016)
        • Agency for Healthcare Research and Quality
        Medical Expenditure Panel Survey: MEPS-HC response rates by panel. Table 1: MEPS-HC overall response rates for public use file.
        (Available at:) (Accessed December 21, 2016)
        • Kessler R.C.
        • Andrews G.
        • Colpe L.J.
        • et al.
        Short screening scales to monitor population prevalences and trends in non-specific psychological distress.
        Psychol Med. 2002; 32: 959-976
        • Mahmoudi E.
        • Meade M.A.
        Disparities in access to health care among adults with physical disabilities: analysis of a representative national sample for a ten-year period.
        Disabil Health J. 2015; 8: 182-190
        • Beatty P.W.
        • Hagglund K.J.
        • Neri M.T.
        • Dhont K.R.
        • Clark M.J.
        • Hilton S.A.
        Access to health care services among people with chronic or disabling conditions: patterns and predictors.
        Arch Phys Med Rehabil. 2003; 84: 1417-1425
        • Reichard A.
        • Stransky M.
        • Phillips K.
        • McClain M.
        • Drum C.
        Prevalence and reasons for delaying and foregoing necessary care by the presence and type of disability among working-age adults.
        Disabil Health J. 2017; 10: 39-47
        • Diab M.E.
        • Johnston M.V.
        Relationships between level of disability and receipt of preventive health services.
        Arch Phys Med Rehabil. 2004; 85: 749-757