Disability and receipt of clinical preventive services among women.
BACKGROUND
More individuals are surviving catastrophic injuries and living longer with persistent disability; however, their receipt of clinical preventive services is not well understood as compared with those without disabilities given the dual focus of care on both primary prevention and the prevention of secondary complications related to their disabilities.


METHODS
Longitudinal analyses of 1999-2002 Medical Expenditure Survey (MEPS). Study sample consisted of 3,183 community-dwelling women aged 51-64 years and followed for 2 full years. Women with disabilities were defined as having reported any limitation in any area of activity of daily living in 2 years. Recommended clinical preventive services were defined as receiving the following at the recommended intervals: colorectal, cervical, and breast cancer; cholesterol screening; and influenza immunization. chi(2) tests and multiple logistic regressions were used to examine variations in use of clinical preventive services.


RESULTS
Overall, 23% of the women in the study (n = 835) were disabled. Disabled women, however, were less likely to receive mammography and Pap smears within the recommended intervals. However, disabled women were more likely to receive influenza immunization, cholesterol screening, and colorectal screening within the recommended intervals. Among the disabled, usual source of care and health insurance remained significant predictors of receipt of clinical preventive services across all types,


CONCLUSIONS
Disabled women were less likely to receive some of the cancer screening services, suggesting a need for targeted interventions to promote breast cancer and cervical cancer screening. Increased access to health care insurance and health care providers may also help.
Wei
Wenhui
W
Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey 08854, USA. weiwenhui@gmail.com
Findley
Patricia A
PA
Sambamoorthi
Usha
U
D001943:Breast Neoplasms / Q000517:prevention & control; D015179:Colorectal Neoplasms / Q000517:prevention & control; D006233:Persons with Disabilities; D005260:Female; D005833:Genital Neoplasms, Female / Q000517:prevention & control; D006279:Health Maintenance Organizations / Q000191:economics; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D065006:Papanicolaou Test; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014626:Vaginal Smears / Q000706:statistics & numerical data; D016387:Women's Health; D014932:Women's Health Services / Q000706:statistics & numerical data*