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CMS Disability Index Identifies Care Disparities, Access Issues

Using the newly developed Disability Index, CMS identified disparities in care access and quality among patients with disabilities.

CMS Disability Index identifies care disparities and access issues

Source: Thinkstock

By Jessica Kent

- Physical and mental disabilities have a significant impact on individuals’ ability to access healthcare, obtain quality services, and manage associated social determinants of health, a recent report from CMS reveals.

According to CMS, an estimated 12 percent to 30 percent of Americans have a disability.  Around 5 percent of non-institutionalized Americans face the most severe disabilities, while an additional 8 percent are “somewhat impaired.”

Individuals who are more severely disabled are more likely to report poor health, have lower incomes, and have received less education than those who aren’t severely disabled, demonstrating disparities in care access and quality among these patients.

To identify existing gaps in care quality and access for these individuals, CMS developed a continuously-scored weighted index of disability, derived from data from the 2014-2015 NHIS Adult Functioning and Disability (AFD) supplement survey.

The Disability Index reflects the presence and severity of five types of disability, including hearing, seeing, walking, cognition, and self-care.

CMS used self-rated health as the criterion measure to derive the weights attached to each disability type.

The results showed that severity of mobility limitations was the strongest predictor of self-rated health, followed by self-care, cognition, vision, and hearing.

Individuals with more severe disabilities also reported significantly higher socioeconomic challenges and disadvantages.

Among the 87 percent of Americans classified as “least impaired” - which includes those with no disability at all - thirty-three percent held Bachelor’s degrees. In comparison, only 20 percent of those who are somewhat impaired and 13 percent of those most impaired had graduated with a 4-year degree.

Additionally, of those who are least impaired, 11 percent reported an annual income of over $75,000. Just four percent of individuals who are somewhat impaired and only one percent of those who are most impaired reported the same.

When compared to the somewhat impaired group, the most impaired individuals were more frequently non-white, had lower English language proficiency, and were less educated.

By revealing the care disparities that exist among patients with disabilities, CMS expects that the Disability Index will allow stakeholders to eliminate gaps in care, as well as expand this method to improve care for other patient populations.

“With the index, researchers will be able to measure the extent to which quality of care and access to care vary along a single dimension. They will also be able to potentially assess whether there is heterogeneity in disparities across people with different levels of impairment.,” the organization concluded.  

“This method can be used as a guideline for researchers to standardize the index to other populations of interest.”


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