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. 2000 Jun;90(6):955–961. doi: 10.2105/ajph.90.6.955

Mobility impairments and use of screening and preventive services.

L I Iezzoni 1, E P McCarthy 1, R B Davis 1, H Siebens 1
PMCID: PMC1446260  PMID: 10846515

Abstract

OBJECTIVES: Primary care for people with disabilities often concentrates on underlying debilitating disorders to the exclusion of preventive health concerns. This study examined use of screening and preventive services among adults with mobility problems (difficulty walking, climbing stairs, or standing for extended periods). METHODS: The responses of non-institutionalized adults to the 1994 National Health Interview Survey, including the disability and Healthy People 2000 supplements, were analyzed. Multivariable logistic regressions predicted service use on the basis of mobility level, demographic characteristics, and indicators of health care access. RESULTS: Ten percent of the sample reported some mobility impairment; 3% experienced major problems. People with mobility problems were as likely as others to receive pneumonia and influenza immunizations but were less likely to receive other services. Adjusted odds ratios for women with major mobility difficulties were 0.6 (95% confidence interval [CI] = 0.4, 0.9) for the Papanicolaou test and 0.7 (95% CI = 0.5, 0.9) for mammography. CONCLUSIONS: More attention should be paid to screening and preventive services for people with mobility difficulties. Shortened appointment times, physically inaccessible care sites, and inadequate equipment could further compromise preventive care for this population.

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Selected References

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  1. Andriacchi R. Primary care for persons with disabilities. The internal medicine perspective. Am J Phys Med Rehabil. 1997 May-Jun;76(3 Suppl):S17–S20. doi: 10.1097/00002060-199705001-00005. [DOI] [PubMed] [Google Scholar]
  2. Barratt A., Irwig L., Glasziou P., Cumming R. G., Raffle A., Hicks N., Gray J. A., Guyatt G. H. Users' guides to the medical literature: XVII. How to use guidelines and recommendations about screening. Evidence-Based Medicine Working Group. JAMA. 1999 Jun 2;281(21):2029–2034. doi: 10.1001/jama.281.21.2029. [DOI] [PubMed] [Google Scholar]
  3. Burns T. J., Batavia A. I., Smith Q. W., DeJong G. Primary health care needs of persons with physical disabilities: what are the research and service priorities? Arch Phys Med Rehabil. 1990 Feb;71(2):138–143. [PubMed] [Google Scholar]
  4. Calkins D. R., Rubenstein L. V., Cleary P. D., Davies A. R., Jette A. M., Fink A., Kosecoff J., Young R. T., Brook R. H., Delbanco T. L. Failure of physicians to recognize functional disability in ambulatory patients. Ann Intern Med. 1991 Mar 15;114(6):451–454. doi: 10.7326/0003-4819-114-6-451. [DOI] [PubMed] [Google Scholar]
  5. Calkins D. R., Rubenstein L. V., Cleary P. D., Davies A. R., Jette A. M., Fink A., Kosecoff J., Young R. T., Brook R. H., Delbanco T. L. Functional disability screening of ambulatory patients: a randomized controlled trial in a hospital-based group practice. J Gen Intern Med. 1994 Oct;9(10):590–592. doi: 10.1007/BF02599291. [DOI] [PubMed] [Google Scholar]
  6. Cassel C. K., Besdine R. W., Siegel L. C. Restructuring Medicare for the next century: what will beneficiaries really need? Health Aff (Millwood) 1999 Jan-Feb;18(1):118–131. doi: 10.1377/hlthaff.18.1.118. [DOI] [PubMed] [Google Scholar]
  7. Chan L., Doctor J. N., MacLehose R. F., Lawson H., Rosenblatt R. A., Baldwin L. M., Jha A. Do Medicare patients with disabilities receive preventive services? A population-based study. Arch Phys Med Rehabil. 1999 Jun;80(6):642–646. doi: 10.1016/s0003-9993(99)90166-1. [DOI] [PubMed] [Google Scholar]
  8. Clark R. E., Ricketts S. K., McHugo G. J. Measuring hospital use without claims: a comparison of patient and provider reports. Health Serv Res. 1996 Jun;31(2):153–169. [PMC free article] [PubMed] [Google Scholar]
  9. DeJong G. Primary care for persons with disabilities. An overview of the problem. Am J Phys Med Rehabil. 1997 May-Jun;76(3 Suppl):S2–S8. doi: 10.1097/00002060-199705001-00002. [DOI] [PubMed] [Google Scholar]
  10. Degnan D., Harris R., Ranney J., Quade D., Earp J. A., Gonzalez J. Measuring the use of mammography: two methods compared. Am J Public Health. 1992 Oct;82(10):1386–1388. doi: 10.2105/ajph.82.10.1386. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Dolan P. The effect of experience of illness on health state valuations. J Clin Epidemiol. 1996 May;49(5):551–564. doi: 10.1016/0895-4356(95)00532-3. [DOI] [PubMed] [Google Scholar]
  12. Freedman V. A., Martin L. G. Understanding trends in functional limitations among older Americans. Am J Public Health. 1998 Oct;88(10):1457–1462. doi: 10.2105/ajph.88.10.1457. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Gans B. M., Mann N. R., Becker B. E. Delivery of primary care to the physically challenged. Arch Phys Med Rehabil. 1993 Dec;74(12 Spec No):S15–S19. [PubMed] [Google Scholar]
  14. Gordon N. P., Hiatt R. A., Lampert D. I. Concordance of self-reported data and medical record audit for six cancer screening procedures. J Natl Cancer Inst. 1993 Apr 7;85(7):566–570. doi: 10.1093/jnci/85.7.566. [DOI] [PubMed] [Google Scholar]
  15. Iezzoni L. I. When walking fails. JAMA. 1996 Nov 20;276(19):1609–1613. doi: 10.1001/jama.276.19.1609. [DOI] [PubMed] [Google Scholar]
  16. Kelly-Hayes M., Jette A. M., Wolf P. A., D'Agostino R. B., Odell P. M. Functional limitations and disability among elders in the Framingham Study. Am J Public Health. 1992 Jun;82(6):841–845. doi: 10.2105/ajph.82.6.841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Kutner N. G., Ory M. G., Baker D. I., Schechtman K. B., Hornbrook M. C., Mulrow C. D. Measuring the quality of life of the elderly in health promotion intervention clinical trials. Public Health Rep. 1992 Sep-Oct;107(5):530–539. [PMC free article] [PubMed] [Google Scholar]
  18. Nelson E., Conger B., Douglass R., Gephart D., Kirk J., Page R., Clark A., Johnson K., Stone K., Wasson J. Functional health status levels of primary care patients. JAMA. 1983 Jun 24;249(24):3331–3338. [PubMed] [Google Scholar]
  19. Peters L. Women's health care: approaches in delivery to physically disabled women. Nurse Pract. 1982 Jan;7(1):34-7, 48. [PubMed] [Google Scholar]
  20. Petersen R. L., Saag K., Wallace R. B., Doebbeling B. N. Influenza and pneumococcal vaccine receipt in older persons with chronic disease: a population-based study. Med Care. 1999 May;37(5):502–509. doi: 10.1097/00005650-199905000-00009. [DOI] [PubMed] [Google Scholar]
  21. Roberts R. O., Bergstralh E. J., Schmidt L., Jacobsen S. J. Comparison of self-reported and medical record health care utilization measures. J Clin Epidemiol. 1996 Sep;49(9):989–995. doi: 10.1016/0895-4356(96)00143-6. [DOI] [PubMed] [Google Scholar]
  22. Stewart M. A., Buck C. W. Physicians' knowledge of and response to patients' problems. Med Care. 1977 Jul;15(7):578–585. doi: 10.1097/00005650-197707000-00005. [DOI] [PubMed] [Google Scholar]
  23. Wartman S. A., Morlock L. L., Malitz F. E., Palm E. Impact of divergent evaluations by physicians and patients of patients' complaints. Public Health Rep. 1983 Mar-Apr;98(2):141–145. [PMC free article] [PubMed] [Google Scholar]
  24. Zapka J. G., Bigelow C., Hurley T., Ford L. D., Egelhofer J., Cloud W. M., Sachsse E. Mammography use among sociodemographically diverse women: the accuracy of self-report. Am J Public Health. 1996 Jul;86(7):1016–1021. doi: 10.2105/ajph.86.7.1016. [DOI] [PMC free article] [PubMed] [Google Scholar]

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