Surveying Physicians to Understand Health Care Disparities Affecting Persons with Disability and Identify Approaches to Improve Their Care

根据2020年的健康人，美国残疾人经历了大量的 保健差距。越来越多的研究，主要涉及个人和重点 与残疾人的小组访谈，记录了导致这些问题的因素， 保健差距。一些因素反映了个人的属性，信仰和偏好， 残疾人。然而，残疾人报告的其他贡献者涉及 卫生保健提供系统、政策以及态度和行动中的系统性障碍 医生和其他医疗保健专业人员。尽管如此，相对较少的研究 检查了医生对这些障碍的看法、实践和理解， 为残疾人提供护理的促进者，他们的法律的责任， 适应这些患者，并建议提高护理质量， 人口这一证据缺口引起了人们的关注，因为医生在决定 患者接受哪些服务，启动物理和通信调节，设置 临床遭遇的语气，从而调解医疗保健差异。 这个项目的总体目标是了解有助于保健的因素 从门诊医生的角度看残疾人的差距 环境，并利用这些知识，为改善护理提出可行的建议。给定 这个为期三年的跨学科项目有三个具体目标： 1.开展医生实践和态度调查（SOPPA），询问初级保健和 选定的专科医生，了解照顾残疾人的障碍和促进因素， 残疾在门诊设置和他们的建议，以改善这种护理。 2.使用SOPPA进行调查，然后分析420名执业初级保健和420名 全国执业专科医生（共840人完成调查）。 3.根据SOPPA的调查结果，广泛的文献综述，关键线人访谈和输入 从不同类型的残疾人中，制定一个"最佳做法"战略工具包， 减少残疾人的保健差距，提高保健质量， 通过额外的医生和患者访谈来评估这些建议。 改善残疾人的健康和保健是一个关键的健康问题。 2020年优先。这将是第一个研究全国医生如何处理 照顾残疾人，并提出可在当地实施的各种战略 减少差距，为这一不断增长的人口提供公平的照顾。

According to Healthy People 2020, Americans with disability experience substantial health care disparities. A growing body of research, primarily involving individual and focus group interviews with persons with disability, has documented factors contributing to these health care disparities. Some factors reflect the personal attributes, beliefs, and preferences of individuals with disability. However, other contributors reported by persons with disability relate to systematic barriers within health care delivery systems, policies, and the attitudes and actions of physicians and other health care professionals. Nonetheless, relatively little research has examined the views, practices, and understanding of physicians about the barriers and facilitators to providing care to persons with disability, their legal responsibilities to accommodate these patients, and recommendations for improving quality of care for this population. This evidence gap raises concerns since physicians play central roles in deciding which services patients receive, initiating physical and communication accommodations, setting the tone of clinical encounters, and thus mediating health care disparities. The overall goals of this project are to understand factors that contribute to health care disparities for persons with disability from the perspective of physicians practicing in outpatient settings and to use this knowledge to make feasible recommendations for improving care. Given these overall goals, this 3-year, interdisciplinary project has 3 Specific Aims: 1. Develop the Survey of Physicians' Practices and Attitudes (SOPPA) to ask primary care and selected specialist physicians about barriers and facilitators to caring for persons with disability in outpatient settings and their recommendations to improve this care. 2. Use SOPPA to conduct and then analyze a survey of 420 practicing primary care and 420 practicing specialist physicians nationwide (total = 840 completed surveys). 3. Based on SOPPA's findings, broad literature reviews, key informant interviews, and input from persons with diverse types of disability, develop a toolkit of “best practice” strategies for reducing health care disparities and improving quality of care for persons with disability and evaluate these recommendations through additional physician and patient interviews. Improving the health and health care of individuals with disability is a critical Healthy People 2020 priority. This will be the first study to examine how physicians nationwide approach caring for persons with disability and to suggest various strategies that could be applied locally to decrease disparities and achieve equitable care for this growing population.