Bingham Shawn C, Beatty Phillip W
National Rehabilitation Hospital, Center for Health and Disability Research, 1016 16th St. NW Suite 400, Washington, DC 20036, USA.
Disabil Rehabil. 2003 May 6;25(9):487-90. doi: 10.1080/0963828031000071723.
To determine rates of access to assistive equipment and medical rehabilitation services among people with disabilities in the US, and to determine whether health plan type is associated with rates of access to these health services.
Results were derived from a nationwide US survey sample of people with cerebral palsy, multiple sclerosis or spinal cord injury. Analyses were restricted to working-age adults (n=500). Need for, and receipt of (1) assistive equipment in the last 12 months, and (2) rehabilitative services in the last 3 months, was determined.
Over half of the sample indicated a need for assistive equipment in the last 12 months. Nearly a third of those who indicated a need did not receive assistive equipment every time it was needed. Forty per cent of the sample indicated a need for rehabilitative services in the last 3 months, and over half of those indicating a need did not receive rehabilitative services every time they were needed. Access rates did not differ appreciably between respondents covered by managed care and fee-for-service health plans.
Emphasis in healthcare for people with disabilities should shift from traditional acute healthcare models that focus on functional restoration, to preventive services, and maintenance of function, health and independence.
确定美国残疾人获得辅助设备和医疗康复服务的比例，并确定健康计划类型是否与这些医疗服务的获得比例相关。
结果来自对美国全国范围内患有脑瘫、多发性硬化症或脊髓损伤的人群的调查样本。分析仅限于工作年龄的成年人（n = 500）。确定了在过去12个月内对（1）辅助设备的需求以及接受情况，以及在过去3个月内对（2）康复服务的需求以及接受情况。
超过一半的样本表示在过去12个月内需要辅助设备。在表示有需求的人中，近三分之一的人在每次需要时并未获得辅助设备。40%的样本表示在过去3个月内需要康复服务，在表示有需求的人中，超过一半的人在每次需要时并未获得康复服务。参加管理式医疗和按服务收费健康计划的受访者之间的获得比例没有明显差异。
残疾人医疗保健的重点应从专注于功能恢复的传统急性医疗模式，转向预防服务以及功能、健康和独立性的维持。
