More Than Ramps : A Guide to Improving Health Care Quality and Access for People with Disabilities

Nearly twenty percent of Americans live today with some sort of disability, and this number will grow in coming decades as the population ages. Despite this, the U.S. health care system is not set up to provide care comfortably, safely, and efficiently to persons with disabilities. Individuals with disabilities can therefore face significant barriers to obtaining high quality health care. Some barriers result from obvious impediments, such as doors without automatic openers and examining tables that are too high. Other barriers arise from faulty communication between patients and health care professionals, including misconceptions among clinicians about the daily lives, preferences, values, and abilities of persons with disabilities. Yet additional barriers relate to health insurance limits on items and services essential to maximizing health and independence. This book examines the health care experiences of persons who are blind, deaf, hard of hearing, or who have difficulties using their legs, arms, or hands. The book then outlines strategies for overcoming or circumventing barriers to care, starting by just asking persons with disabilities about workable solutions. Creating safe and accessible health care for persons with disabilities will likely benefit everyone at some point. This book has three parts. The first part looks at the historical roots of healthcare access for persons with disabilities in the United States. The second part discusses the current situation and the special challenges for those with disabilities. The third part looks forward to discuss the ways in which healthcare quality and access can improve. Nearly Twenty Percent Of Americans Live Today With Some Disability - A Number That Will Grow As The Baby Boomers Age. Despite This, The U.s. Health Care System Is Ill Equipped To Provide Optimal, Safe, And Efficient Care To This Population. Significant Barriers Still Block People With Disabilities From Receiving High-quality Health Care..this Book Examines These Barriers, Then Proposes Solutions To Make Health Care Accessible And Welcoming To People With Disabilities. This Book Examines These Barriers, Then Proposes Solutions To Make Health Care Accessible And Welcoming To People With Disabilities. It Focuses On Adults Who Are Blind, Deaf, Hard Of Hearing, Or Who Have Difficulties Using Their Legs, Arms, Or Hands. The Book Draws Upon Stories Told To The Authors By Persons With These Conditions As Well As Reviews Of National Surveys, Governmental Policies, And Current Practices. I: Setting The Stage: Disability And Access To Health Care In The United States: Roots Of The Problem -- Defining Disability -- Health Insurance And Accessing The Health Care System -- Ii: Health Care Experiences Of People With Disabilities: Finding Care -- Getting Into And Around Health Care Settings -- Challenges To Interpersonal Communication -- Etiquette During Physical Examinations And Interactions With Office Staff -- Clinical Competence And Technical Communication -- Pushing Against Boundaries Of The Health Care System -- Iii: Improving Health Care For People With Disabilities: Using Universal Design To Accommodate All -- Self-management And Advocacy -- Improving Patient-clinician Communication -- Accessible Communication And Information -- Designing Accessible Health Care Settings -- The Internet And Information Technologies -- Healthy And Accessible Communities -- Appendix 1: Internet Resources Addressing General Disability And Health Care Topics -- Appendix 2: Internet Resources Addressing Specific Disabilities, Diseases, And Disorders -- Appendix 3: Suggestions For Improving Accessibility Of Health Care Services -- Appendix 4:identifying Disability Using National Survey Data. Lisa I. Iezzoni, Bonnie L. O'day. Includes Bibliographical References (p. 333-353) And Index. ## Abstract Nearly 20% of Americans live today with some disability, and this number will grow as the “baby boomers” age. Despite this, the U.S. health care system is ill equipped to provide optimal, safe, and efficient care to this population. Significant barriers still block people with disabilities from receiving high quality health care. This book examines these barriers then proposes solutions to make health care accessible and welcoming to people with disabilities, focusing on adults who are blind, deaf, hard of hearing, or who have difficulties using their legs, arms, or hands. The book draws upon stories told by persons with these conditions and reviews of national surveys, governmental policies, and current practices. Some barriers are obvious, such as examining tables that are too high. Other problems arise from faulty communication between patients and health care professionals, including misconceptions among clinicians about the daily lives, preferences, values, and abilities of patients with disabilities. Yet others relate to restrictive health insurance policies. Finding patient-centered solutions to these many impediments will take more than simply building ramps. The first part of the book examines broad social and health insurance policies affecting people with disabilities. The second part discusses current barriers to health care, while the third proposes ways to overcome these hurdles and improve care. Using universal design principles, these solutions recognize that creating safe and accessible health care for people with disabilities will benefit virtually everyone at some point in their lives. Many Americans live with some sort of disability and this book in three parts looks initially at the historical roots of healthcare access for those with disabilites. The second part discusses the current situation and the final part discusses the ways in which healthcare quality and access can improve