Tomlinson Mark, Swartz Leslie, Officer Alana, Chan Kit Yee, Rudan Igor, Saxena Shekhar
Department of Psychology, Stellenbosch University, Stellenbosch, South Africa.
Lancet. 2009 Nov 28;374(9704):1857-62. doi: 10.1016/S0140-6736(09)61910-3.
International evidence shows that people with disabilities have many unmet health and rehabilitation needs, face barriers in accessing mainstream health-care services, and consequently have poor health. Inadequate specific information is available about the prevalence and patterns of health conditions of people with disabilities, effective interventions, and policy-relevant research about what works to improve health and functioning of people with disabilities. In view of the urgency of the issues at stake and scarcity of resources, research contributing to improvement of health of people with disabilities needs to be prioritised. We invited 82 stakeholders to list and score research options, with the priority-setting method of the Child Health and Nutrition Research Initiative. 83 research questions were assessed for answerability, applicability, sensitivity, support within the context, and equity. The leading research priority was identification of barriers that people with disabilities have in accessing health services at different levels, and finding the best possible strategies to integrate their needs into primary health-care systems and ensure local delivery. Results showed that addressing specific impairments is secondary to ensuring that health systems provide adequately for all people with disabilities. Our findings are a call for urgent attention to the issue of access to appropriate health care for people with disabilities, especially in low-income and middle-income countries.
国际证据表明，残疾人有许多未得到满足的健康和康复需求，在获得主流医疗服务方面面临障碍，因此健康状况较差。关于残疾人健康状况的患病率和模式、有效干预措施以及有关改善残疾人健康和功能的有效措施的政策相关研究，目前可获得的具体信息不足。鉴于所涉问题的紧迫性和资源的稀缺性，需要优先开展有助于改善残疾人健康状况的研究。我们邀请了82名利益相关者，采用儿童健康与营养研究倡议的优先事项确定方法，列出并对研究选项进行评分。对83个研究问题进行了可回答性、适用性、敏感性、背景支持和公平性评估。首要研究重点是确定残疾人在获得不同层面医疗服务时面临的障碍，并找到将他们的需求纳入初级卫生保健系统并确保在当地提供服务的最佳策略。结果表明，在确保卫生系统为所有残疾人提供充分服务方面，解决特定损伤问题是次要的。我们的研究结果呼吁人们紧急关注残疾人获得适当医疗保健的问题，特别是在低收入和中等收入国家。
