Data on Difficulties with Physical and Communications Access in Health Care Facilities

Many people have vivid memories of medical procedures and the instructions they received, such as, “Just hop up, look here, read this, listen up, don’t breathe, and stay still!”

June Isaacson Kailes (2006)

Although the committee encountered many personal accounts of access barriers in health care facilities, it located very few consumer or patient survey data on these problems. In their recent examination of the financial, physical, and other barriers to accessible health care, Iezzoni and O’Day (2006) reported no findings on such barriers from data from the disability supplement to the National Health Interview Survey or other surveys. The authors relied primarily on interviews, focus groups, and their own observations and experiences to describe access problems and their consequences.

DeJong and colleagues (2002) have observed that health services researchers have tended to overlook people with disabilities, and to the extent that that is true, it may contribute to the limited research on environmental barriers. Moreover, occupational therapists and others knowledgeable about rehabilitation and the barriers that people encounter in health care facilities may not gravitate to health services research (see, e.g., Andresen et al. [2006]).

Two recent surveys suggest the scope of the accessibility problem in health care facilities. One survey, which involved approximately 400 Californians with mobility limitations, found that nearly one in five people surveyed had problems with the main entrance to their physician’s office and one-third had problems entering examination rooms (Markwalder, 2005). Among those using wheelchairs, 45 percent reported difficulty using mammography and other imaging equipment, 69 percent reported difficulty using physical examination tables, and 60 percent reported problems with inaccessible weight scales. More than 90 percent of people with vision problems did not receive medical information in alternative formats.

A second survey of approximately 400 people nationwide, which was conducted by the Rehabilitation Engineering Research Center on Accessible Instrumentation, found that respondents identified physical examination tables, radiology equipment, exercise and rehabilitation equipment, and weight scales as the most difficult-to-use equipment in health care settings (Winters et al., 2007). Safety was a primary concern, as were comfort, ease or possibility of transferring, and poor visual displays.

These survey findings are consistent with those from a small study by Mele and colleagues (2005). In extended face-to-face interviews with 20

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