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How do adults with physical disability experience primary care? A nationwide cross-sectional survey of access among patients in England
Objectives Almost a quarter of adults in England report a longstanding condition limiting physical activities. However, recent overseas evidence suggests poorer access to healthcare for disabled people. This study aimed to compare patient-reported access to English primary care for adults with and w...
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| Published in: | BMJ open 2014-08, Vol.4 (8), p.e004714-e004714 |
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| description | Objectives Almost a quarter of adults in England report a longstanding condition limiting physical activities. However, recent overseas evidence suggests poorer access to healthcare for disabled people. This study aimed to compare patient-reported access to English primary care for adults with and without physical disability. Design Secondary analysis of the 2010/11 General Practice Patient Survey (response rate 35.9%) using logistic regression. Setting and participants 1 780 977 patients, from 8384 English general practices, who provided information on longstanding conditions limiting basic physical activity. 41 389 of these patients reported unmet need to see a doctor in the previous 6 months. Outcomes Difficulty getting to the general practitioner (GP) surgery as a reason for unmet need to see a doctor in the preceding 6 months; difficulty getting into the surgery building. Results Estimated prevalence of physical disability was 17.2% (95% CI 17.0% to 17.3%). 17.9% (95% CI 17.4% to 18.4%) of patients with an unmet need to see a doctor were estimated to experience this due to difficulty getting to the surgery, and 2.2% (95% CI 2.2% to 2.3%) of all patients registered with a GP were estimated to experience difficulty getting into surgery buildings. Adjusting for gender, age, health status and employment, difficulty getting to the surgery explaining unmet need was more likely for patients with physical disability than for those without. Similarly, difficulty getting into surgery buildings was more likely among physically disabled patients. Both associations were stronger among patients aged 65–84 years. Conclusions Adults in England with physical disability experience worse physical access into primary care buildings than those without. Physical disability is also associated with increased unmet healthcare need due to difficulty getting to GP premises, compared with the experience of adults without physical disability. Increasing age further exacerbates these problems. Access to primary care in England for patients with physical disability needs improving. |
| doi_str_mv | 10.1136/bmjopen-2013-004714 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4127932</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4039111981</sourcerecordid><originalsourceid>FETCH-LOGICAL-b472t-829934a7d68b1b465ba66efa96f90eb23d38fdfe794b056911de56c8e5f8e8b83</originalsourceid><addsrcrecordid>eNqNUc1u1DAYjBCIVqVPgIQsceGS1nZsx7mAqqpQpEpc4Gz558uuV4kd7KTbfQJeGy-7VC0nfLFlz4y_mamqtwRfENKISzNu4gShppg0NcasJexFdUoxY7XAnL98cj6pznPe4LIY7zinr6sTygluWcNOq1-3cYtcRNotw5zR1s9rNK132Vs9IOezNn7w8w7BwwTJQ7CApuRHnXbI6gSf0BUKevYxbL0DZFPMuc5g9zdFIC_pHnYo9khbCzkjPcawQlNhQCjf-YBuwmrQwb2pXvV6yHB-3M-qH59vvl_f1nffvny9vrqrDWvpXEvadQ3TrRPSEMMEN1oI6HUn-g6DoY1rZO96aDtmMBcdIQ64sBJ4L0Ea2ZxVHw-602JGcLaMkfSgjp5U1F49fwl-rVbxXjFC266hReDDUSDFnwvkWY0-WxiKCYhLVqQkLHErSVug7_-BbuKSSi4F1UpOO0nEXrA5oP6El6B_HIZgte9aHbtW-67VoevCevfUxyPnb7MFcHEAFPZ_Kf4Gity4pw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1785298162</pqid></control><display><type>article</type><title>How do adults with physical disability experience primary care? A nationwide cross-sectional survey of access among patients in England</title><source>BMJ_英国医学会期刊</source><source>BMJ Journals (Open Access)</source><source>ProQuest - Publicly Available Content Database</source><source>PubMed Central</source><creator>Popplewell, Nicola T A ; Rechel, Boika P D ; Abel, Gary A</creator><creatorcontrib>Popplewell, Nicola T A ; Rechel, Boika P D ; Abel, Gary A</creatorcontrib><description>Objectives Almost a quarter of adults in England report a longstanding condition limiting physical activities. However, recent overseas evidence suggests poorer access to healthcare for disabled people. This study aimed to compare patient-reported access to English primary care for adults with and without physical disability. Design Secondary analysis of the 2010/11 General Practice Patient Survey (response rate 35.9%) using logistic regression. Setting and participants 1 780 977 patients, from 8384 English general practices, who provided information on longstanding conditions limiting basic physical activity. 41 389 of these patients reported unmet need to see a doctor in the previous 6 months. Outcomes Difficulty getting to the general practitioner (GP) surgery as a reason for unmet need to see a doctor in the preceding 6 months; difficulty getting into the surgery building. Results Estimated prevalence of physical disability was 17.2% (95% CI 17.0% to 17.3%). 17.9% (95% CI 17.4% to 18.4%) of patients with an unmet need to see a doctor were estimated to experience this due to difficulty getting to the surgery, and 2.2% (95% CI 2.2% to 2.3%) of all patients registered with a GP were estimated to experience difficulty getting into surgery buildings. Adjusting for gender, age, health status and employment, difficulty getting to the surgery explaining unmet need was more likely for patients with physical disability than for those without. Similarly, difficulty getting into surgery buildings was more likely among physically disabled patients. Both associations were stronger among patients aged 65–84 years. Conclusions Adults in England with physical disability experience worse physical access into primary care buildings than those without. Physical disability is also associated with increased unmet healthcare need due to difficulty getting to GP premises, compared with the experience of adults without physical disability. Increasing age further exacerbates these problems. Access to primary care in England for patients with physical disability needs improving.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2013-004714</identifier><identifier>PMID: 25107434</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adolescent ; Adult ; Adults ; Age ; Aged ; Aged, 80 and over ; Bias ; Cross-Sectional Studies ; Disability ; Disabled Persons - statistics & numerical data ; Employment ; England ; Female ; Gender ; Handicapped accessibility ; Health care access ; Health Care Surveys - statistics & numerical data ; Health Services Accessibility - statistics & numerical data ; Health Services Needs and Demand - statistics & numerical data ; Health Services Research ; Humans ; Learning disabilities ; Male ; Middle Aged ; Patients ; People with disabilities ; Population ; Primary care ; Primary Health Care - statistics & numerical data ; Questionnaires ; Response rates ; Surgery ; Young Adult</subject><ispartof>BMJ open, 2014-08, Vol.4 (8), p.e004714-e004714</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2014 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b472t-829934a7d68b1b465ba66efa96f90eb23d38fdfe794b056911de56c8e5f8e8b83</citedby><cites>FETCH-LOGICAL-b472t-829934a7d68b1b465ba66efa96f90eb23d38fdfe794b056911de56c8e5f8e8b83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1785298162/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1785298162?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>112,113,230,315,733,786,790,891,3213,25783,27582,27583,27957,27958,37047,37048,44625,53827,53829,75483</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25107434$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Popplewell, Nicola T A</creatorcontrib><creatorcontrib>Rechel, Boika P D</creatorcontrib><creatorcontrib>Abel, Gary A</creatorcontrib><title>How do adults with physical disability experience primary care? A nationwide cross-sectional survey of access among patients in England</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>Objectives Almost a quarter of adults in England report a longstanding condition limiting physical activities. However, recent overseas evidence suggests poorer access to healthcare for disabled people. This study aimed to compare patient-reported access to English primary care for adults with and without physical disability. Design Secondary analysis of the 2010/11 General Practice Patient Survey (response rate 35.9%) using logistic regression. Setting and participants 1 780 977 patients, from 8384 English general practices, who provided information on longstanding conditions limiting basic physical activity. 41 389 of these patients reported unmet need to see a doctor in the previous 6 months. Outcomes Difficulty getting to the general practitioner (GP) surgery as a reason for unmet need to see a doctor in the preceding 6 months; difficulty getting into the surgery building. Results Estimated prevalence of physical disability was 17.2% (95% CI 17.0% to 17.3%). 17.9% (95% CI 17.4% to 18.4%) of patients with an unmet need to see a doctor were estimated to experience this due to difficulty getting to the surgery, and 2.2% (95% CI 2.2% to 2.3%) of all patients registered with a GP were estimated to experience difficulty getting into surgery buildings. Adjusting for gender, age, health status and employment, difficulty getting to the surgery explaining unmet need was more likely for patients with physical disability than for those without. Similarly, difficulty getting into surgery buildings was more likely among physically disabled patients. Both associations were stronger among patients aged 65–84 years. Conclusions Adults in England with physical disability experience worse physical access into primary care buildings than those without. Physical disability is also associated with increased unmet healthcare need due to difficulty getting to GP premises, compared with the experience of adults without physical disability. Increasing age further exacerbates these problems. Access to primary care in England for patients with physical disability needs improving.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bias</subject><subject>Cross-Sectional Studies</subject><subject>Disability</subject><subject>Disabled Persons - statistics & numerical data</subject><subject>Employment</subject><subject>England</subject><subject>Female</subject><subject>Gender</subject><subject>Handicapped accessibility</subject><subject>Health care access</subject><subject>Health Care Surveys - statistics & numerical data</subject><subject>Health Services Accessibility - statistics & numerical data</subject><subject>Health Services Needs and Demand - statistics & numerical data</subject><subject>Health Services Research</subject><subject>Humans</subject><subject>Learning disabilities</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>People with disabilities</subject><subject>Population</subject><subject>Primary care</subject><subject>Primary Health Care - statistics & numerical data</subject><subject>Questionnaires</subject><subject>Response rates</subject><subject>Surgery</subject><subject>Young Adult</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>PIMPY</sourceid><recordid>eNqNUc1u1DAYjBCIVqVPgIQsceGS1nZsx7mAqqpQpEpc4Gz558uuV4kd7KTbfQJeGy-7VC0nfLFlz4y_mamqtwRfENKISzNu4gShppg0NcasJexFdUoxY7XAnL98cj6pznPe4LIY7zinr6sTygluWcNOq1-3cYtcRNotw5zR1s9rNK132Vs9IOezNn7w8w7BwwTJQ7CApuRHnXbI6gSf0BUKevYxbL0DZFPMuc5g9zdFIC_pHnYo9khbCzkjPcawQlNhQCjf-YBuwmrQwb2pXvV6yHB-3M-qH59vvl_f1nffvny9vrqrDWvpXEvadQ3TrRPSEMMEN1oI6HUn-g6DoY1rZO96aDtmMBcdIQ64sBJ4L0Ea2ZxVHw-602JGcLaMkfSgjp5U1F49fwl-rVbxXjFC266hReDDUSDFnwvkWY0-WxiKCYhLVqQkLHErSVug7_-BbuKSSi4F1UpOO0nEXrA5oP6El6B_HIZgte9aHbtW-67VoevCevfUxyPnb7MFcHEAFPZ_Kf4Gity4pw</recordid><startdate>20140808</startdate><enddate>20140808</enddate><creator>Popplewell, Nicola T A</creator><creator>Rechel, Boika P D</creator><creator>Abel, Gary A</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140808</creationdate><title>How do adults with physical disability experience primary care? A nationwide cross-sectional survey of access among patients in England</title><author>Popplewell, Nicola T A ; Rechel, Boika P D ; Abel, Gary A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b472t-829934a7d68b1b465ba66efa96f90eb23d38fdfe794b056911de56c8e5f8e8b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adults</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bias</topic><topic>Cross-Sectional Studies</topic><topic>Disability</topic><topic>Disabled Persons - statistics & numerical data</topic><topic>Employment</topic><topic>England</topic><topic>Female</topic><topic>Gender</topic><topic>Handicapped accessibility</topic><topic>Health care access</topic><topic>Health Care Surveys - statistics & numerical data</topic><topic>Health Services Accessibility - statistics & numerical data</topic><topic>Health Services Needs and Demand - statistics & numerical data</topic><topic>Health Services Research</topic><topic>Humans</topic><topic>Learning disabilities</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>People with disabilities</topic><topic>Population</topic><topic>Primary care</topic><topic>Primary Health Care - statistics & numerical data</topic><topic>Questionnaires</topic><topic>Response rates</topic><topic>Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Popplewell, Nicola T A</creatorcontrib><creatorcontrib>Rechel, Boika P D</creatorcontrib><creatorcontrib>Abel, Gary A</creatorcontrib><collection>BMJ Journals (Open Access)</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database (ProQuest)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest - Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Popplewell, Nicola T A</au><au>Rechel, Boika P D</au><au>Abel, Gary A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How do adults with physical disability experience primary care? A nationwide cross-sectional survey of access among patients in England</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2014-08-08</date><risdate>2014</risdate><volume>4</volume><issue>8</issue><spage>e004714</spage><epage>e004714</epage><pages>e004714-e004714</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Objectives Almost a quarter of adults in England report a longstanding condition limiting physical activities. However, recent overseas evidence suggests poorer access to healthcare for disabled people. This study aimed to compare patient-reported access to English primary care for adults with and without physical disability. Design Secondary analysis of the 2010/11 General Practice Patient Survey (response rate 35.9%) using logistic regression. Setting and participants 1 780 977 patients, from 8384 English general practices, who provided information on longstanding conditions limiting basic physical activity. 41 389 of these patients reported unmet need to see a doctor in the previous 6 months. Outcomes Difficulty getting to the general practitioner (GP) surgery as a reason for unmet need to see a doctor in the preceding 6 months; difficulty getting into the surgery building. Results Estimated prevalence of physical disability was 17.2% (95% CI 17.0% to 17.3%). 17.9% (95% CI 17.4% to 18.4%) of patients with an unmet need to see a doctor were estimated to experience this due to difficulty getting to the surgery, and 2.2% (95% CI 2.2% to 2.3%) of all patients registered with a GP were estimated to experience difficulty getting into surgery buildings. Adjusting for gender, age, health status and employment, difficulty getting to the surgery explaining unmet need was more likely for patients with physical disability than for those without. Similarly, difficulty getting into surgery buildings was more likely among physically disabled patients. Both associations were stronger among patients aged 65–84 years. Conclusions Adults in England with physical disability experience worse physical access into primary care buildings than those without. Physical disability is also associated with increased unmet healthcare need due to difficulty getting to GP premises, compared with the experience of adults without physical disability. Increasing age further exacerbates these problems. Access to primary care in England for patients with physical disability needs improving.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>25107434</pmid><doi>10.1136/bmjopen-2013-004714</doi><oa>free_for_read</oa></addata></record> |
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| source | BMJ_英国医学会期刊; BMJ Journals (Open Access); ProQuest - Publicly Available Content Database; PubMed Central |
| subjects | Adolescent Adult Adults Age Aged Aged, 80 and over Bias Cross-Sectional Studies Disability Disabled Persons - statistics & numerical data Employment England Female Gender Handicapped accessibility Health care access Health Care Surveys - statistics & numerical data Health Services Accessibility - statistics & numerical data Health Services Needs and Demand - statistics & numerical data Health Services Research Humans Learning disabilities Male Middle Aged Patients People with disabilities Population Primary care Primary Health Care - statistics & numerical data Questionnaires Response rates Surgery Young Adult |
| title | How do adults with physical disability experience primary care? A nationwide cross-sectional survey of access among patients in England |
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