• Ann. Intern. Med. · Mar 2013

    Access to subspecialty care for patients with mobility impairment: a survey.

    • Tara Lagu, Nicholas S Hannon, Michael B Rothberg, Annalee S Wells, K Laurie Green, McAllister O Windom, Katherine R Dempsey, Penelope S Pekow, Jill S Avrunin, Aaron Chen, and Peter K Lindenauer.
    • Center for Quality of Care Research, Baystate Medical Center, Springfield, Massachusetts 01199, USA. lagutc@gmail.com
    • Ann. Intern. Med. 2013 Mar 19; 158 (6): 441446441-6.

    BackgroundAdults who use wheelchairs have difficulty accessing physicians and receive less preventive care than their able-bodied counterparts.ObjectiveTo learn about the accessibility of medical and surgical subspecialist practices for patients with mobility impairment.DesignA telephone survey was used to try to make an appointment for a fictional patient who was obese and hemiparetic, used a wheelchair, and could not self-transfer from chair to examination table.Setting256 endocrinology, gynecology, orthopedic surgery, rheumatology, urology, ophthalmology, otolaryngology, and psychiatry practices in 4 U.S. cities.PatientsNone.MeasurementsAccessibility of the practice, reasons for lack of accessibility, and planned method of transfer of the patient to an examination table.ResultsOf 256 practices, 56 (22%) reported that they could not accommodate the patient, 9 (4%) reported that the building was inaccessible, 47 (18%) reported inability to transfer a patient from a wheelchair to an examination table, and 22 (9%) reported use of height-adjustable tables or a lift for transfer. Gynecology was the subspecialty with the highest rate of inaccessible practices (44%).LimitationSmall numbers of practices in 8 subspecialties in 4 cities and use of a fictional patient with obesity and hemiparesis limit generalizability.ConclusionMany subspecialists could not accommodate a patient with mobility impairment because they could not transfer the patient to an examination table. Better awareness among providers about the requirements of the Americans with Disabilities Act and the standards of care for patients in wheelchairs is needed.Primary Funding SourceNone.

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