Slide 1
Agency for Healthcare Research and Quality (AHRQ)
Advancing Excellence in Health Care
www.ahrq.gov
Catalyzing Quality Improvements in Health Care Services for Women of Color with Disability
Rosaly Correa-de-Araujo, MD, MSc, PhD
Director, Women's Health & Gender-Based Research
Pre-Conference Addressing the Healthcare & Wellness Issues of Women of Color with Disabilities, "Minding the Gap: Access, Availability, and Services National Leadership Summit on Eliminating Racial & Ethnic Disparities in Health
Washington DC, Jan 8, 2006
Slide 2
Americans With Disabilities Act of 1990
Source: US Department of Justice, 2000
Slide 3
Disability in the United States
Source: Healthy People 2010; Coyle et al, 2002
Slide 4
Key Health Issues in Women with Disability
Slide 5
Healthy People 2010 & Disability
Slide 6
Disparities in Health Care
Disability vs. No Disability
Slide 7
Satisfaction with Health Care
Source: Veltman et al, 2001 and 2002
Slide 8
Perception of Quality of Primary Care among Persons w/ Physical Disability
Inquiries on Health Promotion
Percentage |
|
FA |
61.7% |
E |
58.2% |
V |
10% |
Source: Branigan et al, 2001
Slide 9
Secondary Conditions
Source: Coyle et al, 2002
Slide 10
Defining & Measuring Disability
Slide 11
National Healthcare Disparities Report - NHDR
Problems w/Quality of Care
Slide 12
National Healthcare Disparities Report - NHDR
Problems w/Access to Care
Populations |
Percentage |
P |
11% |
NP |
9% |
MI |
7% |
HI |
4% |
Slide 13
NHDR: 2002 Preventive Services for Medicare Disabled Community Residents under Age 65
Mammogram
Population |
Percentage |
T |
48.31% |
W |
44.22% |
B |
52.58% |
H |
49.46% |
Functional Limitation |
Percentage |
None |
46 |
IADL only |
51 |
1 to 2 ADLS |
50 |
3 or more ADLS |
45 |
At least 1 ADL/IADL |
49 |
PAP Smears
Population |
Percentage |
T |
48.31% |
W |
52.03% |
B |
55.54% |
H |
54.47% |
Functional Limitation |
Percentage |
None |
52 |
IADL only |
58 |
1 to 2 ADLS |
53 |
3 or more ADLS |
44 |
At least 1 ADL/IADL |
52 |
Slide 14
NHDR: 2002 Preventive Services for Medicare Disabled Community Residents under Age 65
Home FBT (W 17%; M 17%)
Population |
Percentage |
T |
16% |
W |
17% |
B |
12% |
H |
15% |
Functional Limitation |
Percentage |
None |
9 |
IADL only |
18 |
1 to 2 ADLS |
19 |
3 or more ADLS |
18 |
At least 1 ADL/IADL |
18 |
Colonoscopy/Sigmoidoscopy (W 34%; M 27%)
Population |
Percentage |
T |
31% |
W |
31% |
B |
28% |
H |
36% |
Functional Limitation |
Percentage |
None |
24 |
IADL only |
29 |
1 to 2 ADLS |
36 |
3 or more ADLS |
32 |
At least 1 ADL/IADL |
33 |
Slide 15
NHDR: 2002 Preventive Services for Medicare Disabled Community Residents under Age 65
Flu Shots (W 42%; M 43%)
Population |
Percentage |
T |
42.42% |
W |
43.28% |
B |
38.5% |
H |
34.82% |
Functional Limitation |
Percentage |
None |
37 |
IADL only |
46 |
1 to 2 ADLS |
46 |
3 or more ADLS |
40 |
At least 1 ADL/IADL |
44 |
Pneumonia (W 42%; M 44%)
Population |
Percentage |
T |
43% |
W |
44% |
B |
42% |
H |
33% |
Functional Limitation |
Percentage |
None |
38 |
IADL only |
41 |
1 to 2 ADLS |
49 |
3 or more ADLS |
44 |
At least 1 ADL/IADL |
45 |
Slide 16
NHDR: 2002 Preventive Services for Medicare Disabled Community Residents under Age 65
Bone Mass (W 32%; M 7%)
Population |
Percentage |
T |
19% |
W |
21% |
B |
16% |
H |
16% |
Functional Limitation |
Percentage |
None |
13 |
IADL only |
22 |
1 to 2 ADLS |
22 |
3 or more ADLS |
16 |
At least 1 ADL/IADL |
20 |
Eye Exam (W 48%; M 40%)
Population |
Percentage |
T |
44% |
W |
43% |
B |
49% |
H |
50% |
Functional Limitation |
Percentage |
None |
41 |
IADL only |
42 |
1 to 2 ADLS |
49 |
3 or more ADLS |
44 |
At least 1 ADL/IADL |
45 |
Slide 17
NHDR: 2002 Preventive Services for Medicare Disabled Community Residents under Age 65
Dental Care (W 35%; M 35%)
Population |
Percentage |
T |
35% |
W |
38% |
B |
26% |
H |
38% |
Functional Limitation |
Percentage |
None |
38 |
IADL only |
31 |
1 to 2 ADLS |
35 |
3 or more ADLS |
36 |
At least 1 ADL/IADL |
34 |
Slide 18
NHDR: 2002 Medicare Disabled Community Residents < Age 65 - Satisfaction w/ Care
Care by Specialists (W 90%; M 93%)
Population |
Percentage |
T |
92% |
W |
91% |
B |
97% |
H |
94% |
Functional Limitation |
Percentage |
None |
93 |
IADL only |
93 |
1 to 2 ADLS |
96 |
3 or more ADLS |
85 |
At least 1 ADL/IADL |
91 |
Ease Phone Answers (W 85%; M 89%)
Population |
Percentage |
T |
87% |
W |
86% |
B |
95% |
H |
94% |
Functional Limitation |
Percentage |
None |
90 |
IADL only |
87 |
1 to 2 ADLS |
90 |
3 or more ADLS |
80 |
At least 1 ADL/IADL |
86 |
Slide 19
NHDR: 2002 Medicare Disabled Community Residents < Age 65 - Satisfaction w/ Care
Waited at least 30' (W 30%; M 38%)
Population |
Percentage |
T |
34% |
W |
31% |
B |
38% |
H |
47% |
Functional Limitation |
Percentage |
None |
30 |
IADL only |
33 |
1 to 2 ADLS |
37 |
3 or more ADLS |
34 |
At least 1 ADL/IADL |
35 |
Hospital Outpatient (W 78%; M 72%)
Home Health Care (W 13%; M 10%)
Population |
Percentage |
|
H-OP |
HHC |
|
T |
75 |
11 |
W |
74 |
11 |
B |
76 |
12 |
H |
73 |
9 |
Functional Limitation |
Percentage |
|
H-OP |
HHC |
|
None |
75 |
5 |
IADL only |
69 |
8 |
1 to 2 ADLS |
79 |
11 |
3 or more ADLS |
75 |
23 |
At least 1 ADL/IADL |
74 |
13 |
Slide 20
Challenges in Reporting on Gender, Racial/Ethnic Disparities in Disability
Slide 21
Improving National Data Collection
Slide 22
Disparities in Health Care What We Don't Know
Slide 23
Final Remarks
Slide 24
Final Remarks
Slide 25
Thank you!
Last Revised: July 24, 2006