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Structural Impairments That Limit Access to Health Care for Patients With Disabilities
Kristi L. Kirschner, MD;
Mary Lou Breslin, MA;
Lisa I. Iezzoni, MD, MSc
JAMA. 2007;297:1121-1125.
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The following 3 cases represent substandard care for patients with disabilities, yet they occurred recently at US tertiary care medical centers with the latest technologies and well-qualified physicians. These failures resulted from basic, "low-tech" structural deficiencies—lack of accessible call systems, diagnostic equipment, and examination tables.
Joe is paralyzed, dependent on a ventilator, and unable to speak. His hospital room was at the end of the corridor and had no accessible call system to summon assistance. When his ventilator became disconnected and then was not promptly recognized, Joe became extremely anxious about being in a hospital.
Susan, who uses a wheelchair, had trouble breathing. She needed an echocardiogram, which was performed while she sat in her wheelchair. The echocardiogram was of poor technical quality and yielded little information.
Chuck has paraplegia and new rectal bleeding. The gastroenterologist refused . . . [Full Text of this Article] Legal and Policy Contexts
Author Affiliations: Rehabilitation Institute of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Ill (Dr Kirschner); Disability Rights Education and Defense Fund, Berkeley, Calif (Ms Breslin); and Harvard Medical School, Institute for Health Policy, Massachusetts General Hospital, Boston (Dr Iezzoni).
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