Will expanding health care coverage for people with disabilities increase their employment and earnings? Evidence from an analysis of the SSI work incentive program

Abstract Aging and disability are normative processes that extend across the lifespan. However, ageism and ableism are incorporated into many of our practices, programs, and policies—devaluing the lives of older adults and people aging with disabilities and ultimately preventing their full participation in society. Ageism and ableism are closely connected. For example, both systems identify impairment as an individual and social liability. As recent studies have demonstrated, this has real world implications for the quantity and quality of health care requested, delivered, and received by both older adults and people with disabilities. In this session, we discuss the connections between these two forms of oppression and present recent work by researchers in both fields and the FrameWorks Institute that shows how to transform our cultural ideas of aging and disability and development more inclusive policies and services. Part of a symposium sponsored by the Lifelong Disabilities Interest Group.

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Urban economic reform and access to health care coverage in the People's Republic of China

Social Science & Medicine ◽

10.1016/0277-9536(94)00419-t ◽

1995 ◽

Vol 41 (8) ◽

pp. 1073-1084 ◽

Cited By ~ 43

Author(s):

Colleen M. Grogan

Keyword(s):

Health Care ◽

Economic Reform ◽

Access To Health Care ◽

People’S Republic Of China ◽

People's Republic Of China ◽

Health Care Coverage ◽

Republic Of China ◽

Urban Economic ◽

Access To Health

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A National Accessibility Audit of Primary Health Care Facilities in Brazil—Are People with Disabilities Being Denied Their Right to Health?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062953 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2953

Author(s):

Alexandro Pinto ◽

Luciana Sepúlveda Köpcke ◽

Renata David ◽

Hannah Kuper

Keyword(s):

Health Care ◽

Primary Health Care ◽

People With Disabilities ◽

Health Care Facilities ◽

Internal Space ◽

Major Barrier ◽

Healthcare Facilities ◽

Primary Health ◽

Care Facilities ◽

Primary Health Care Facilities

Poor accessibility of healthcare facilities is a major barrier for people with disabilities when seeking care. Yet, accessibility is rarely routinely audited. This study reports findings from the first national assessment of the accessibility of primary health care facilities, undertaken in Brazil. A national accessibility audit was conducted by trained staff of all 38,812 primary healthcare facilities in Brazil in 2012, using a 22-item structured questionnaire. An overall accessibility score was created (22 items), and three sub-scales: external accessibility (eight items), internal accessibility (eight items), information accessibility (six items). The main finding is that the overall accessibility score of primary care facilities in Brazil was low (mean of 22, standard deviation (SD) of 0.21, on a 0–100 scale). Accessibility of different aspects of the healthcare facilities was also low, including external space (mean = 31.0, SD = 2.0), internal space (18.9, 1.9) and accessibility features for people with other visual or hearing impairments (6.3, SD = 1.0). Scores were consistently better in the least poor regions of Brazil and in facilities in larger municipality size (indicating more urban areas). In conclusion, large-scale accessibility audits are feasible to undertake. Poor accessibility means that people with disabilities will experience difficulties in accessing healthcare, and this is a violation of their rights according to international and Brazilian laws.

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Targeted reduction in neurosurgical laboratory utilization: resident-led effort at a single academic institution

Journal of Neurosurgery ◽

10.3171/2013.8.jns13512 ◽

2014 ◽

Vol 120 (1) ◽

pp. 173-177 ◽

Cited By ~ 21

Author(s):

Seunggu J. Han ◽

Rajiv Saigal ◽

John D. Rolston ◽

Jason S. Cheng ◽

Catherine Y. Lau ◽

...

Keyword(s):

Health Care ◽

Quality Improvement ◽

Financial Incentives ◽

Laboratory Tests ◽

Medical Center ◽

Hospital Setting ◽

Cost Savings ◽

Fiscal Year ◽

Incentive Program ◽

Neurosurgical Patients

Object Given economic limitations and burgeoning health care costs, there is a need to minimize unnecessary diagnostic laboratory tests. Methods The authors studied whether a financial incentive program for trainees could lead to fewer unnecessary laboratory tests in neurosurgical patients in a large, 600-bed academic hospital setting. The authors identified 5 laboratory tests that ranked in the top 13 of the most frequently ordered during the 2010–2011 fiscal year, yet were least likely to be abnormal or influence patient management. Results In a single year of study, there was a 47% reduction in testing of serum total calcium, ionized calcium, chloride, magnesium, and phosphorus. This reduction led to a savings of $1.7 million in billable charges to health care payers and $75,000 of direct costs to the medical center. In addition, there were no significant negative changes in the quality of care delivered, as recorded in a number of metrics, showing that this cost savings did not negatively impact patient care. Conclusions Engaging physician trainees in quality improvement can be successfully achieved by financial incentives. Through the resident-led quality improvement incentive program, neurosurgical trainees successfully reduced unnecessary laboratory tests, resulting in significant cost savings to both the medical center and the health care system. Similar programs that engage trainees could improve the value of care being provided at other academic medical centers.

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Effective Universal Coverage of Diabetes Mellitus Type 2 in Chile

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.1630.2871 ◽

2017 ◽

Vol 25 (0) ◽

Cited By ~ 2

Author(s):

Sara Guerrero-Núñez ◽

Sandra Valenzuela-Suazo ◽

Patricia Cid-Henríquez

Keyword(s):

Diabetes Mellitus ◽

Health Care ◽

Diabetes Mellitus Type 2 ◽

Health Program ◽

Cardiovascular Health ◽

Universal Coverage ◽

Diabetes Mellitus Type ◽

Health Care Coverage ◽

Universal Health

ABSTRACT Objective: determine the prevalence of Effective Universal Coverage of Diabetes Mellitus Type 2 in Chile and its relation with the variables: Health Care Coverage of Diabetes Mellitus Type 2; Average of diabetics with metabolic control in 2011-2013; Mortality Rate for Diabetes Mellitus; and Percentage of nurses participating in the Cardiovascular Health Program. Method: cross-sectional descriptive study with ecological components that uses documentary sources of the Ministry of Health. It was established that there is correlation between the Universal Effective Coverage of Diabetes Mellitus Type 2 and the independent variables; it was applied the Pearson Coefficient, being significant at the 0.05 level. Results: in Chile Universal Health Care Coverage of Diabetes Mellitus Type 2 (HbA1c<7% estimated population) is less than 20%; this is related with Mortality Rate for Diabetes Mellitus and Percentage of nurses participating in the Cardiovascular Health Program, being significant at the 0.01 level. Conclusion: effective prevalence of Universal Health Coverage of Diabetes Mellitus Type 2 is low, even though some regions stand out in this research and in the metabolic control of patients who participate in health control program; its relation with percentage of nurses participating in the Cardiovascular Health Program represents a challenge and an opportunity for the health system.

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