Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado, Aurora, CO, USA.
Department of Family Medicine, School of Medicine, University of Colorado, Aurora, CO, USA.
J Gen Intern Med. 2021 Aug;36(8):2370-2377. doi: 10.1007/s11606-020-06582-8. Epub 2021 Feb 9.
Patients with disabilities often require healthcare accommodations in order to access high-quality, equitable healthcare services. While attention has been paid to accommodation needs in specific disability populations, limited research to date has explored healthcare accommodations that cross-cut diverse disability populations.
To identify a deeper understanding regarding accommodations in healthcare settings that could apply across disability populations and promote equitable healthcare.
We conducted qualitative focus groups with patients with disabilities and caregivers to understand their experiences and preferences for healthcare accommodations.
We recruited patients and caregivers across all major disability categories to participate in focus groups. Participants were recruited through advocacy organizations and healthcare settings in Southeastern Minnesota.
A total of eight focus groups were conducted with 56 participants. Participants described their healthcare experiences and desires for healthcare accommodations. The multidisciplinary research team recorded, transcribed verbatim, and coded all focus groups. The team thematically coded transcripts using content analysis within and across focus groups to identify major themes.
Patients identified four challenges and corresponding steps healthcare team could take to promote equitable care: (1) consistent documentation of disabilities and needed accommodations in the medical record; (2) allowance for accommodations to the environment, including adapting physical space, physical structures, and scheduling and rooming processes; (3) provide accommodations for administrative tasks, such as completing paper or electronic forms; and (4) adapt communication during interactions, such as speaking slower or using terms that patients can easily understand.
These identified themes represent specific opportunities for healthcare teams to effectively provide accessible care to patients with disabilities. Many of the accommodations require minimal financial investment, but did require behavioral changes by the healthcare team to ensure equitable healthcare.
残疾患者通常需要医疗保健方面的便利设施，以获得高质量、公平的医疗保健服务。虽然人们已经关注到特定残疾人群体的便利设施需求，但迄今为止，关于跨越不同残疾人群体的医疗保健便利设施的研究有限。
更深入地了解医疗保健环境中的便利设施，这些便利设施可以适用于不同残疾人群体，并促进公平的医疗保健。
我们对残疾患者及其护理人员进行了定性焦点小组讨论，以了解他们对医疗保健便利设施的体验和偏好。
我们招募了来自所有主要残疾类别的患者和护理人员参加焦点小组。参与者是通过东南明尼苏达州的宣传组织和医疗保健机构招募的。
共进行了 8 次焦点小组讨论，共有 56 名参与者。参与者描述了他们的医疗保健体验和对医疗保健便利设施的需求。多学科研究团队记录、逐字转录并对所有焦点小组进行编码。团队使用内容分析在焦点小组内和跨焦点小组对转录本进行主题编码，以确定主要主题。
患者确定了四个挑战和医疗团队可以采取的相应步骤来促进公平护理：（1）在医疗记录中一致记录残疾和所需的便利设施；（2）允许环境适应，包括调整物理空间、物理结构以及日程安排和房间安排流程；（3）为行政任务提供便利设施，例如填写纸质或电子表格；（4）在互动中调整沟通，例如说话慢一些或使用患者容易理解的术语。
这些确定的主题代表了医疗团队为残疾患者提供有效便利护理的具体机会。许多便利设施只需要很少的财务投资，但需要医疗团队做出行为改变，以确保公平的医疗保健。
