Unmet Needs and Health Services Appraisal: The Role of Disability Type and Service Delivery Approach.

TitleUnmet Needs and Health Services Appraisal: The Role of Disability Type and Service Delivery Approach.
Publication TypeConference Paper
Year of Publication2014
AuthorsOwen R, Bowers A, Heller T
Conference LocationPoster presented at the American Public Health Association’s Annual Conference, New Orleans, Louisiana
Abstract

Background: This study examines unmet needs for and appraisal of health services for people with disabilities in Medicaid receiving managed care (MC) versus fee-for-service (FFS) service delivery approaches by disability type.

Methods:  The study uses survey data from 817 individuals receiving Medicaid in a Midwestern state. The disability type splits people into groups corresponding to their Medicaid waiver: intellectual/developmental (IDD, 193 respondents), physical (PD, 279), and mental health (MH, 198) disabilities and a group who don’t fit those groups (Other, 143). The delivery approach identifies people as receiving MC or FFS.  The survey measures health care appraisal and total unmet needs. A two-way ANOVA for those two outcomes with disability type and delivery approach as independent variables was followed by regressions including age, gender, race, disability, and delivery approach as independent variables.

Results: Both health appraisal and unmet needs are significantly related to disability group but not with delivery approach. For unmet needs, other (1.59) and PD (2.19) have significantly (p<.05) fewer unmet needs than MH (3.16) and IDD (3.37). However, for health appraisal, only the other group had significantly (p<.05) higher ratings than ID or MH. Results of regression analyses show that unmet needs is negatively related (p>.01) to health appraisal and unmet needs is higher for people with physical and mental health disabilities (p<.01) than for people without those conditions.

Conclusion: Unmet needs are important for health plans (MC or FFS) to address. These results specify for which disability types unmet needs are highest so healthcare providers can address them.