Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA 01545, USA.
Disabil Health J. 2011 Oct;4(4):209-18. doi: 10.1016/j.dhjo.2011.05.003.
The employment rate among adults with disabilities is significantly lower than that among adults without disabilities. Ensuring access to rehabilitative and other health care services may help to address health-related barriers to employment for working-age people with disabilities. This study examined the relationship of unmet need for 6 disability-related health care services to current employment status among working-age adults with disabilities enrolled in the Massachusetts Medicaid (MassHealth Standard) program.
Study participants included 436 MassHealth Standard members aged 19 to 64 who responded to the 2005/2006 MassHealth Employment and Disability Survey. Variables included members' demographic characteristics; Medicaid health plan and Medicare enrollment; members' self-report of potentially disabling conditions and current health status; access to health care as well as need and unmet need for 6 specific disability-related health care services (medications, mental health services, substance abuse services, medical supplies, durable medical equipment, personal assistance services); and current employment status.
Fifteen percent of members reported currently working. Logistic regression analysis showed that (controlling for demographics, disability, health status, and other factors) members with greater unmet need were significantly less likely to be working (odds ratio = 0.58; 95% confidence interval = 0.33 to 0.99). Members' experience of unmet need was significantly greater for physical health services (supplies, durable medical equipment, personal assistance services) than for behavioral health services (mental health and substance abuse services) or medications. Working members generally rated services as important to work. Approximately 10% to 22% of nonworking members thought they would be able to work if needs were met.
Meeting unmet needs for disability-related health care services may result in modest increases in employment among certain working-age adults with disabilities enrolled in the Massachusetts Medicaid program.
残疾成年人的就业率明显低于非残疾成年人。确保获得康复和其他医疗保健服务可能有助于解决与工作相关的残疾成年人的健康障碍。本研究调查了马萨诸塞州医疗补助计划（马萨诸塞州医疗保健标准）中登记的工作年龄残疾成年人的 6 种残疾相关医疗服务需求未得到满足与当前就业状况之间的关系。
研究参与者包括 436 名年龄在 19 至 64 岁之间的马萨诸塞州医疗保健标准成员，他们对 2005/2006 年马萨诸塞州医疗保健就业和残疾调查做出了回应。变量包括成员的人口统计学特征；医疗补助计划和医疗保险的参与情况；成员对潜在残疾状况和当前健康状况的自我报告；获得医疗保健的情况以及对 6 种特定残疾相关医疗服务（药物、心理健康服务、药物滥用服务、医疗用品、耐用医疗设备、个人援助服务）的需求和未满足的需求；以及当前的就业状况。
15%的成员报告目前正在工作。逻辑回归分析表明（控制人口统计学、残疾、健康状况和其他因素），需求未得到满足的成员工作的可能性显著降低（优势比=0.58；95%置信区间=0.33 至 0.99）。成员对身体健康服务（用品、耐用医疗设备、个人援助服务）的未满足需求明显大于对行为健康服务（心理健康和药物滥用服务）或药物的需求。工作成员通常认为服务对工作很重要。大约 10%至 22%的非工作成员认为如果满足需求，他们将能够工作。
满足残疾相关医疗服务的未满足需求可能会导致马萨诸塞州医疗补助计划中某些登记工作年龄残疾成年人的就业率略有增加。
