Physical accessibility in primary health care settings: results from California on-site reviews.
BACKGROUND
People with disabilities report physical barriers in doctors' offices that affect the quality of care. Whether most or few doctors' offices are accessible is not known. We address this gap with data on 2389 primary care provider facilities.


OBJECTIVE
The analysis seeks to describe overall primary care office physical accessibility and identify (1) in which areas offices meet access criteria, (2) which accessibility criteria are most often not met, and (3) whether there are urban/non-urban differences.


METHODS
Reviewers rated medical offices using a 55-item instrument that assessed parking, exterior access, building entrance, interior public spaces, doctor's office interior, and the presence of accessible exam equipment. Five health plans that serve California Medicaid patients conducted reviews of providers signed with their plans. Data from the plans were merged, coded, and a descriptive analysis conducted.


RESULTS
An accessible weight scale was present in 3.6% and a height adjustable examination table in 8.4% of the sites. Other high prevalence access barriers were in bathrooms and examination rooms. Parking, exterior access, building access, and interior public spaces generally met the access criteria, except for van accessible parking.


CONCLUSIONS
These findings provide a base for quantitative expectations about accessibility nationwide, and indicate significant barriers exist. They show it is possible to conduct a large number of accessibility site reviews, providing one model to meet the Affordable Care Act requirement for provider accessibility information. Physical access is important as it may affect the quality of care and willingness of patients to engage in preventive care.
School of Social Work, Syracuse University, Syracuse, NY 13244, USA. mudrick@syr.edu
Nancy R
NR
Mudrick
Mary Lou
ML
Breslin
Mengke
M
Liang
Silvia
S
Yee
D002140:California; D006233:Persons with Disabilities; D004779:Environment Design; D058637:Examination Tables; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008484:Medicaid; D008494:Medical Office Buildings; D009819:Office Visits; D010824:Physicians' Offices; D011320:Primary Health Care; D014186:Transportation; D014481:United States