Discrimination and Other Barriers to Accessing Health Care: Perspectives of Patients with Mild and Moderate Intellectual Disability and Their Carers

People with intellectual disability have a higher prevalence of physical health problems but often experience disparities in accessing health care. In England, a number of legislative changes, policies and recommendations have been introduced to improve health care access for this population. The ai...

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Vydané v:	PloS one Ročník 8; číslo 8; s. e70855
Hlavní autori:	Ali, Afia, Scior, Katrina, Ratti, Victoria, Strydom, Andre, King, Michael, Hassiotis, Angela
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States Public Library of Science 12.08.2013 Public Library of Science (PLoS)
Predmet:	Adult Analysis Caregivers Committees Communication Consent Discrimination England - epidemiology Ethics Ethnicity Female Handicapped accessibility Health care Health care access Health care disparities Health care industry Health care reform Health Care Surveys Health policy Health problems Health sciences Health services Health Services Accessibility Healthcare Disparities Humans Intellectual disabilities Intellectual Disability - epidemiology Learning disabilities Male Medical care discrimination Medical research Medicine Mental health Middle Aged Minority & ethnic groups Observatories Patients Policies Qualitative Research Quality of life Social and Behavioral Sciences Social Discrimination Studies Surveys and Questionnaires Young Adult England United Kingdom > UK
ISSN:	1932-6203, 1932-6203
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Popis
Shrnutí:	People with intellectual disability have a higher prevalence of physical health problems but often experience disparities in accessing health care. In England, a number of legislative changes, policies and recommendations have been introduced to improve health care access for this population. The aim of this qualitative study was to examine the extent to which patients with intellectual disability and their carers experience discrimination or other barriers in accessing health services, and whether health care experiences have improved over the last decade years. Twenty nine participants (14 patient and carer dyads, and one carer) took part in semi-structured interviews. The interviews were audio-taped and transcribed and analysed using thematic analysis. Eight themes were identified. Half the participants thought that the patient had been treated unfairly or had been discriminated against by health services. There were accounts of negative staff attitudes and behaviour, and failure of services to make reasonable adjustments. Other barriers included problems with communication, and accessing services because of lack of knowledge of local services and service eligibility issues; lack of support and involvement of carers; and language problems in participants from minority ethnic groups. Most participants were able to report at least one example of good practice in health care provision. Suggestions for improving services are presented. Despite some improvements to services as a result of health policies and recommendations, more progress is required to ensure that health services make reasonable adjustments to reduce both direct and indirect discrimination of people with intellectual disability.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: The authors have declared that no competing interests exist. Conceived and designed the experiments: AA KS VR AS MK AH. Performed the experiments: AA KS. Analyzed the data: AA KS. Contributed reagents/materials/analysis tools: AA KS VR. Wrote the paper: AA VR KS AS MK AK.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0070855