Patients with disabilities report worse health care experiences

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A study published last week in Health Services Research by Rutgers Health researchers identified notable disparities in health care experiences between people with disabilities and those without, with significant challenges in patient-provider communication and access to timely care.

Researchers analyzed data from the 2021 Medical Expenditure Panel Survey of U.S. adults, and their findings indicated that disabled patients consistently reported worse health care experiences than their non-disabled counterparts. On a 0-to-10 scale measuring overall satisfaction, disabled respondents reported an average rating of 7.98, compared to 8.38 for non-disabled individuals. Those with multiple disabilities reported the lowest satisfaction scores at 7.87.

“Our findings highlight the need for disability-competent and affirming health care, especially at a time when policies and initiatives impacting disabled patients are coming under attack,” said Elizabeth Stone, lead author of the study and faculty member in the Center for Health Services Research at Rutgers Institute for Health, Health Care Policy and Aging Research.

The study identified multiple areas where disabled patients reported worse experiences, including providers failing to listen carefully, spending insufficient time with patients, and offering explanations that were difficult to understand.

Only 49.3% of disabled respondents felt their providers always listened to them carefully, compared to 59.6% of non-disabled respondents. Similarly, 43.7% of disabled patients said their providers consistently spent enough time with them, compared to 54.4% of non-disabled patients.

The study also found variation in experiences based on disability type. People with physical, cognitive and multiple disabilities reported significantly worse interactions with health care providers than those with sensory disabilities, like vision or hearing impairments.

Policy implications of these findings are particularly relevant in the wake of recent challenges to Section 504 of the Rehabilitation Act of 1973, which prohibits disability-based discrimination in federally funded programs. In July 2024, the act was strengthened to enhance protections in health care settings, but a lawsuit filed by 17 states in fall 2024 looks to overturn those regulations.

“Addressing disparities in the quality of health care for patients with disabilities requires unique approaches dependent on people’s specific needs,” said Stone, who is also an instructor of psychiatry at Rutgers Robert Wood Johnson Medical School. “But ultimately, interventions at the structural level are needed to address these concerning disparities in patient experiences.”

With roughly one in four people in the U.S. population living with a disability, the study reinforces the need for health care providers and policymakers to ensure equitable access and high-quality care for all patients.