title: How do adults with physical disability experience primary care? A nationwide cross-sectional survey of access among patients in England.
abstract: OBJECTIVE
  Almost a quarter of adults in England report a longstanding condition limiting physical activities. However, recent overseas evidence suggests poorer access to healthcare for disabled people. This study aimed to compare patient-reported access to English primary care for adults with and without physical disability.
  
  
  METHODS
  Secondary analysis of the 2010/11 General Practice Patient Survey (response rate 35.9%) using logistic regression.
  
  
  METHODS
  1,780,977 patients, from 8384 English general practices, who provided information on longstanding conditions limiting basic physical activity. 41,389 of these patients reported unmet need to see a doctor in the previous 6 months.
  
  
  RESULTS
  Difficulty getting to the general practitioner (GP) surgery as a reason for unmet need to see a doctor in the preceding 6 months; difficulty getting into the surgery building.
  
  
  RESULTS
  Estimated prevalence of physical disability was 17.2% (95% CI 17.0% to 17.3%). 17.9% (95% CI 17.4% to 18.4%) of patients with an unmet need to see a doctor were estimated to experience this due to difficulty getting to the surgery, and 2.2% (95% CI 2.2% to 2.3%) of all patients registered with a GP were estimated to experience difficulty getting into surgery buildings. Adjusting for gender, age, health status and employment, difficulty getting to the surgery explaining unmet need was more likely for patients with physical disability than for those without. Similarly, difficulty getting into surgery buildings was more likely among physically disabled patients. Both associations were stronger among patients aged 65-84 years.
  
  
  CONCLUSIONS
  Adults in England with physical disability experience worse physical access into primary care buildings than those without. Physical disability is also associated with increased unmet healthcare need due to difficulty getting to GP premises, compared with the experience of adults without physical disability. Increasing age further exacerbates these problems. Access to primary care in England for patients with physical disability needs improving.
authors.affiliation: Cambridge Centre for Health Services Research, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
authors.forename: Nicola T A
authors.initials: NT
authors.lastname: Popplewell
authors.affiliation: Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK School of Public Health Research, Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: Boika P D
authors.initials: BP
authors.lastname: Rechel
authors.affiliation: Cambridge Centre for Health Services Research, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Abel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004739:England; D005260:Female; D019538:Health Care Surveys / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Epidemiology; Health Services Administration & Management; Primary Care; Public Health; Rehabilitation Medicine
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