title: Accommodations for patients with disabilities in primary care: a mixed methods study of practice administrators.
abstract: Structural barriers that limit access to health care services for people with disabilities have been identified through qualitative studies; however, little is known about how patients with disabilities are accommodated in the clinical setting when a structural barrier is encountered. The purpose of this study was to identify how primary care medical practices in the United States accommodated people with disabilities when a barrier to service is encountered. Primary care practice administrators from the medical management organization were identified through the organization's website. Sixty-three administrators from across the US participated in this study. Practice administrators reported that patients were examined in their wheelchairs (76%), that parts of the exam where skipped when a barrier was encountered (44%), that patients were asked to bring someone with them (52.4%) or that patients were refused treatment due to an inaccessible clinic (3.2%). These methods of accommodation would not be in compliance with requirements of the Americans with Disabilities Act. There was not a significant difference (p>0.05) in accommodations for patients with disabilities between administrators who could describe the application of the ADA to their clinic and those who could not. Practice administrators need a comprehensive understanding of the array of challenges encountered by patients with disabilities throughout the health care process and of how to best accommodate patients with disabilities in their practice.
authors.affiliation: University of Nevada, Las Vegas. jennifer.pharr@unlv.edu.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Pharr
mesh_terms: D006233:Persons with Disabilities / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys / Q000331:legislation & jurisprudence / Q000379:methods / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000331:legislation & jurisprudence / Q000379:methods*; D016079:Refusal to Treat / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D014481:United States; D014910:Wheelchairs