Addressing Gaps In Care For Patients With Disabilities

Leo Migdal

-Dec 5, 2025, 1:17 PM

Lisa Iezzoni in her motorized wheelchair | Photograph by Jim harrison Addressing Gaps in Care for Patients with Disabilities Behind the Scenes: Associate editor Lydialyle Gibson on why society needs to be more open to talking about disability. Several years ago, Lisa Iezzoni, S.M. ’78, M.D. ’84, one of the most prominent researchers in healthcare and disability, decided to ask doctors what they thought about patients with disabilities.

Their answers were stunning. In interviews and focus groups, physicians from across the country, in communities ranging from rural to urban, admitted to widespread resentments, prejudices, and deficiencies. Respondents included a mix of primary care doctors and specialists in fields like rheumatology and neurology, which are more likely to serve patients who need accommodations. The discussions were held by video conference, and on their screens, physicians could not see that Iezzoni, who has multiple sclerosis, was sitting in a wheelchair. Received 2023 Jun 16; Accepted 2023 Oct 11; Collection date 2023. Open Access This article is licensed under the terms of the Creative Commons Attribution 3.0 IGO License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you...

The use of the World Health Organization’s name, and the use of the World Health Organization’s logo, shall be subject to a separate written licence agreement between the World Health Organization and the user... Note that the link provided below includes additional terms and conditions of the licence. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from... To view a copy of this licence, visit http://creativecommons.org/licenses/by/3.0/igo/. Persons with disabilities experience health inequities in terms of increased mortality, morbidity, and limitations in functioning when compared to the rest of the population.

Many of the poor health outcomes experienced by persons with disabilities cannot be explained by the underlying health condition or impairment, but are health inequities driven by unfair societal and health system factors. A synthesis of the global evidence is needed to identify the factors that hinder equitable access to healthcare services for persons with disabilities, and the interventions to remove these barriers and promote disability inclusion. We conducted a scoping review following the methodological framework proposed by Arksey and O’Malley, Int J Soc Res Methodol 8:19–32. We searched two scholarly databases, namely MEDLINE (Ovid) and Web of Science, the websites of Organizations of Persons with Disabilities and governments, and reviewed evidence shared during WHO-led consultations on the topic of health... We included articles published after 2011 with no restriction to geographical location, the type of underlying impairments or healthcare services. A charting form was developed and used to extract the relevant information for each included article.

Of 11,884 articles identified in the search, we included 182 articles in this review. The majority of sources originated from high-income countries. Barriers were identified worldwide across different levels of the health system (such as healthcare costs, untrained healthcare workforces, issues of inclusive and coordinated services delivery), and through wider contributing factors of health inequities that... However, the interventions to promote equitable access to healthcare services for persons with disabilities were not readily mapped onto those needs, their sources of funding and projected sustainability were often unclear, and few offered... Reducing disparities in health outcomes through practical solutions The American Hospital Association is expanding its work on reducing disparities in health outcomes to include people with disabilities.

The Americans with Disabilities Act defines “disability” as physical or mental impairment that substantially limits one or more life activities, a history or record of such an impairment, or the perception by others that... The solutions below were co-designed by hospital leaders, clinicians and disability advocates during a national convening focused on improving care and outcomes for people with disabilities. Participants identified three areas where hospitals and health systems can take meaningful action: Together, hospitals and health systems can reduce disparities in health outcomes and ensure every patient receives care that is dignified, respectful and responsive to their needs. Health inequities affecting people with disabilities remain a persistent and often overlooked issue within the U.S. healthcare system.

Despite efforts to make healthcare more inclusive, provider biases and financial challenges continue to prevent millions from receiving equitable care. With recent policy pushes for broader health equity, now is the time to address the unique needs of this population. Provider bias and a lack of training on disability-specific care create another layer of inequity. Many healthcare providers have limited knowledge of the unique healthcare needs and challenges faced by people with disabilities. The National Council on Disability (NCD) reports that these gaps in provider training lead to miscommunication, inadequate treatment, and a lack of understanding about the disabilities themselves. This can result in healthcare providers making assumptions about patients’ quality of life or failing to take complaints seriously, impacting the overall quality of care.

Addressing these biases is crucial to ensure that providers offer compassionate, informed care that respects everyone’s needs. Individuals with disabilities often encounter significant financial challenges that impede access to necessary healthcare services. These challenges stem from increased medical expenses, limited employment opportunities, and systemic economic disparities. A comprehensive report by the Financial Health Network reveals that nearly half (46%) of working-age individuals with disabilities have unmanageable levels of debt, and only 51% can pay all their bills on time. This financial instability is exacerbated by the fact that people with disabilities are more likely to live on low incomes. The National Disability Institute reports that 45% of working-age individuals with disabilities have annual household incomes under $30,000, compared to 21% of those without disabilities.

Public safety net programs, such as Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI), are intended to support individuals with disabilities. However, only about a third of working-age individuals with disabilities receive these benefits. Even among those with low incomes and significant barriers to employment, many do not receive the assistance they need. These financial barriers not only limit access to healthcare but also contribute to a cycle of poverty and poor health outcomes. Addressing these challenges requires comprehensive policy interventions aimed at improving employment opportunities, enhancing public benefits, and reducing the additional costs associated with living with a disability. Recent policy efforts seek to address these disparities, but much work remains.

The Americans with Disabilities Act (ADA) laid an essential foundation for disability rights, yet it does not mandate comprehensive healthcare accessibility or provider training. The National Council on Disability’s 2024 Progress Report recommends that policymakers enhance provider training in disability care, increase funding for facility accessibility improvements, and expand Medicaid and Medicare services to cover a broader range... Ensuring health equity for people with disabilities will require more than incremental improvements; it demands systemic change. Addressing physical, educational, and financial barriers within the healthcare system is crucial. By pushing for stronger policies, comprehensive training, and expanded financial support, we can bridge the gap and create a healthcare system that serves everyone equally. Ongoing advocacy and reform are essential to ensure that all individuals, regardless of disability, receive the quality care they deserve.

For many people with disabilities, navigating the healthcare system often remains a complex and sometimes frustrating challenge. From physical barriers in medical facilities to implicit bias and inadequate provider training, people with disabilities regularly encounter hurdles that impact the quality of care they receive. Examining and understanding these disparities can create a more inclusive, accessible, and equitable healthcare system. Disability is not a monolithic experience: it spans physical, sensory, cognitive, and mental health conditions that each have their own unique challenges and needs. According to the World Health Organization, over 1 billion people––about 15% of the global population––live with some form of disability. Despite this, many healthcare systems are still designed without people with disabilities in mind.

Here are some common barriers: These barriers lead to worse health outcomes for people with disabilities. People with disabilities are less likely to receive preventive services like cancer screenings, more likely to experience poor mental health, and at a higher risk for diseases like obesity, diabetes, and cardiovascular disease. But there are as to combat these inequities and move towards more inclusive healthcare such as more training and education on all types of disabilities, policy reform, and patient-centered care. By acknowledging these barriers, addressing systemic gaps, and amplifying disabled voices, it’s possible to make the healthcare system work for everyone.

Addressing Gaps In Care For Patients With Disabilities

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