Center for Health Services Research, Rutgers Institute for Health, Health Care Policy, and Aging Research, 112 Paterson St., New Brunswick, NJ 08901, USA; Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, 671 Hoes Lane, Piscataway, NJ, 08854, USA.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 600 N. Wolfe St., Baltimore, MD, 21287, USA.
Disabil Health J. 2024 Apr;17(2):101547. doi: 10.1016/j.dhjo.2023.101547. Epub 2023 Nov 5.
People with cognitive disabilities such as intellectual and developmental disabilities face significant barriers to accessing high-quality health care services. Barriers may be exacerbated for those with co-occurring mental health conditions.
This study compares patient experiences of health care services between adults with and without cognitive disabilities and, among people with a cognitive disability, those with and without co-occurring mental health conditions.
Cross-sectional analyses were conducted using 2021 Medical Expenditure Panel Survey data, a national U.S. survey, to examine differences in Consumer Assessment of Healthcare Providers and Systems measures.
Adults with cognitive disabilities reported lower satisfaction with health care services compared to the general population (7.62 (95% confidence interval (CI): 7.41-7.83) vs. 8.33 (95% CI: 8.29-8.38) on scale from 0 to 10). Adults with cognitive disabilities were less likely to report that providers listened carefully to them (odds ratio (OR): 0.55, 95% CI: 0.42-0.71), explained things in a way that was easy to understand (OR: 0.48, 95% CI: 0.35-0.66), showed respect for what they had to say (OR: 0.38, 95% CI: 0.29-0.51), spent enough time with them (OR: 0.52, 95% CI: 0.40-0.69), or gave advice that was easy to understand (OR: 0.40, 95% CI: 0.28-0.58) compared to the general population. Among adults with cognitive disabilities, there were no differences based on co-occurring mental health conditions.
Adults with cognitive disabilities report lower satisfaction with health care services driven by worse experiences with the health care system. Policies to increase provider capacity to support this population should be prioritized.
智障和发育障碍等认知障碍患者在获得高质量医疗保健服务方面面临重大障碍。对于同时患有精神健康问题的患者，障碍可能会更加严重。
本研究比较了认知障碍成人与非认知障碍成人以及认知障碍成人中同时患有和不患有精神健康问题的患者在医疗服务体验方面的差异。
使用 2021 年美国全国医疗支出调查（MEPS）的横断面数据分析，考察了医疗保健提供者和系统评估量表（Consumer Assessment of Healthcare Providers and Systems measures）的差异。
与普通人群相比，认知障碍成人对医疗服务的满意度较低（评分范围为 0 至 10，分别为 7.62（95%置信区间（CI）：7.41-7.83）和 8.33（95% CI：8.29-8.38））。认知障碍成人更有可能报告称，医护人员没有认真倾听他们的意见（比值比（OR）：0.55，95% CI：0.42-0.71）、没有以易懂的方式解释问题（OR：0.48，95% CI：0.35-0.66）、没有尊重他们的意见（OR：0.38，95% CI：0.29-0.51）、没有花足够的时间与他们相处（OR：0.52，95% CI：0.40-0.69）或没有提供易懂的建议（OR：0.40，95% CI：0.28-0.58）。在认知障碍成人中，是否同时患有精神健康问题并无差异。
认知障碍成人对医疗服务的满意度较低，这主要是因为他们对医疗服务系统的体验较差。应优先制定增加医疗服务提供者支持这一人群能力的政策。
