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April 2010 ARQH National Healthcare Quality and Disparities Reports

The 2009 Agency for Healthcare Research and Quality’s (AHRQ) National Healthcare Quality and Disparities Reports are out!

In April, 2010 the National Healthcare Quality and Disparities Reports were made available to the public. These reports contain useful information on the quality of healthcare as well as healthcare disparities in the United States. The National Healthcare Disparities Report (NHDR) is one of the reports included in the 2009 National Healthcare Quality and Disparities Reports series.

The NHDR is important to the disability community because it provides insight into the disparities amongst special populations, included individuals with disabilities. A subgroup within the National Healthcare Quality Report/National Healthcare Disparities Report Interagency Work Group was convened to advice AHRQ on disability measures from already existing data that could be used to track healthcare disparities.

AHRQ used the following definition for disability when reviewing data and measuring disparities: “…people with disabilities are those with physical, sensory, and/or mental health conditions that can be associated with a decrease in functioning in such day-to-day activities as bathing, walking, doing everyday chores, and engaging in work or social activities.”

What is important to those in the vision loss field are those data related to “limitations in basic activities”. Vision loss is included within the basic activity because of limitations in activities, “…that depend on sensory functioning (limited to people who are blind or deaf).”

Dental Care

According to the 2009 NHDR, individuals with basic activity limitations were significantly more likely than those without activity limitations to report being unable to get or delayed in getting needed dental care (11.3% compared with 6.4%). These differences were even more startling among black and Hispanic adults with basic activity limitations who reported unable to get or delayed in getting needed dental care compared to adults without basic activity limitations of all racial and ethnic groups.

Individuals with basic activity limitations also reported to be less likely to have had an annual dental visit than those without activity limitations (38.4% compared with 43.3%). And like those unable to get or delayed in getting needed dental care, blacks and Hispanics were less likely than any racial or ethnic group without a disability to have had a dental visit in the last year.

Being Underinsured

Individuals with basic activity limitations were more likely to be underinsured with private health insurance than those individuals without a disability (12.4% compared to 4.4%). Similarly, racial and ethnic minorities with basic activity limitations were more likely to be underinsured that those without a disability.

For those with a basic activity limitation and less than a high school education were more likely than those with at least some college to be underinsured (20.0% compared to 9.2%), however even those with a basic activity limitation and some college education were still less likely to be underinsured than individuals without disabilities with less than a high school education (9.2% compared to 7.9%).

Financial Burden

According to the NHDR, those with basic activity limitations were more likely to be living in families with high medical financial burden than those without a disability (34.1% compared to 15.5%). Similarly to dental care and underinsurance, blacks and Hispanics with basic activity limitations were more likely to be living in families with high medical financial burden than those black and Hispanics without disabilities.

It was also reported that with basic activity limitations and living in poor families were about three times (49.0%) as likely to be in high financial burden situations compared to those living in high-income families (16.4%).

Summary

What can be gleaned from the data reported in the NHDR? The findings of this report tell us is that individuals with disabilities are less likely to receive the care they need, be more likely to be underinsured, and carry a heavier burden from the costs of healthcare.

While, individuals with vision loss were not isolated for the purpose of this study, vision loss was defined within “basic activity limitation”, therefore allowing researchers to infer that individuals with vision loss report to be less likely to receive the care they need, be more likely to be underinsured with private insurance, and experience a heavier burden due to the costs of healthcare.

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