Abstract：
BACKGROUND:A growing number of states are turning to managed care arrangements to provide care to senior and disabled Medicaid beneficiaries. Despite their complex care needs, very little is known about the experience of these individuals in managed care. OBJECTIVE:To document experiences of a sample of aged and disabled Medicaid beneficiaries receiving long-term services and supports through managed care in Iowa and to assess whether these experiences changed over time. METHODS:A purposive sample of 49 aged and disabled beneficiaries enrolled in one of seven HCBS waivers in Iowa was recruited in 2017. Telephone surveys were conducted in 2017 and 2019. A conventional content analysis was used to generate themes, which were then ranked by frequency proportions. Thematic frequencies were compared across waves among repeat respondents. RESULTS:Content analysis yielded seven themes in the following areas: system navigation; service approvals; provider relations; customer service; case management; perception of Iowa's transition to managed care; and oversight. Concerns with service approvals was the most frequently reported theme and within this, issues related to changes in approved services or hours and quality of newly approved services comprised the largest number of references. Beneficiary concerns appeared to grow over time among respondents participating in both survey interview waves. CONCLUSION:The results of this study point to serious and persistent concerns related to access and quality of care under managed care for at least some HCBS waiver participants in Iowa, underscoring the need for a comprehensive evaluation of the program.
journal_name
Disabil Health Jjournal_title
Disability and health journalauthors
Arora K,Rochford H,Todd K,Kaskie Bdoi
10.1016/j.dhjo.2020.100975subject
Has Abstractpub_date
2021-01-01 00:00:00pages
100975issue
1eissn
1936-6574issn
1876-7583pii
S1936-6574(20)30107-2journal_volume
14pub_type
杂志文章abstract：BACKGROUND:This paper is an introduction to four papers that present the findings of the 2007 "State of the Science in Aging with Developmental Disabilities: Charting Lifespan Trajectories and Supportive Environments for Healthy Community Living" symposium. The overall goal of this symposium was to increase our underst...
journal_title：Disability and health journal
pub_type： 杂志文章,评审
doi：10.1016/j.dhjo.2008.04.001
更新日期：2008-07-01 00:00:00
abstract：BACKGROUND:Women with intellectual and developmental disabilities (IDD) are bearing children at increasing rates. However, there is very little research about pregnancy experiences and birth outcomes among women with IDD. No studies to date have examined birth outcomes with a US population-based sample. OBJECTIVE:The ...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2017.02.010
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:Assistive technology (AT) is one strategy to mitigate or eliminate barriers to independence for individuals with disabilities, including those with spina bifida (SB). However, little is known about current use and costs of AT for people with SB, including the cost burden to medical insurance payees. OBJECTI...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2009.10.009
更新日期：2010-07-01 00:00:00
abstract：BACKGROUND:To implement appropriate programs for promoting physical activity (PA) in people who are Deaf, it is important to have valid instruments for assessing PA in this population. OBJECTIVE:The main purpose of this study was to examine the criterion validity of the short form of the International Physical Activit...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2016.06.005
更新日期：2017-01-01 00:00:00
abstract：BACKGROUND:Youth with disabilities experience greater levels of peer victimization and psychosocial distress than non-disabled youth. However, the extent to which exposure to peer victimization mediates the relationship between disability status and psychosocial distress is unknown. OBJECTIVE:To determine whether the ...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2014.09.006
更新日期：2015-04-01 00:00:00
abstract：BACKGROUND:Studies have reported that adolescents with intellectual and developmental disabilities (IDD) have a higher prevalence of obesity due to medication intake, poor diet, and physical inactivity. More importantly, they lack awareness and comprehension to prevent weight problems. Thereby, health-promoting practic...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2019.03.012
更新日期：2019-10-01 00:00:00
abstract：BACKGROUND:Hip osteoarthritis, a common age-associated condition, produces considerable disability that may be influenced by a variety of factors other than age. This study examines the magnitude and impact of the presence of comorbid and/or concurrent depression and anxiety symptoms on the disability experienced befor...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2008.10.001
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:Women with disabilities experience significant health disparities. A barrier to progress in addressing these disparities is the lack of population-based data on their health outcomes, which are needed to plan health care delivery systems. Administrative health data are increasingly being used to measure the ...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2020.100909
更新日期：2020-07-01 00:00:00
abstract：BACKGROUND:The accessibility of public facilities for all is an issue increasingly gaining focus in policy debates, especially regarding the ageing population. OBJECTIVE:This paper describes a psychometric approach to the development of a new instrument for assessing the accessibility of public entrances. METHODS:Ite...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2019.02.007
更新日期：2019-07-01 00:00:00
abstract：BACKGROUND:Prior studies on the impact of disabling work injury have neglected social support as a key mediating factor. This study investigates how permanent impairment from a work injury affects marital formation, an indicator of social support and integration with the potential to affect psychosocial adjustment and ...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2012.10.001
更新日期：2013-01-01 00:00:00
abstract：BACKGROUND:Adults with long-term disability are living longer and may experience accelerated aging. More information is needed to understand the incidence of chronic comorbid medical conditions in this population. OBJECTIVE:To examine the incidence, prevalence, age of onset and predictors of five chronic conditions in...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2016.02.002
更新日期：2016-07-01 00:00:00
abstract：BACKGROUND:Patient at Risk (PAR) is an online database using an emergency information form (EIF) that parents of children with special health care needs (CSHCN) complete to store their child's medical information. Emergency medical service (EMS) providers can then access PAR during medical emergencies or for pre-planni...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2019.100852
更新日期：2020-04-01 00:00:00
abstract：BACKGROUND:Health care improvements have led to increased survival among stroke patients; however, the disability level remains high. These patients require assistance from caregivers, particularly in the first year after stroke. Longitudinal studies of quality of life (QoL) and the factors associated with QoL for both...
journal_title：Disability and health journal
pub_type： 杂志文章,多中心研究
doi：10.1016/j.dhjo.2015.10.007
更新日期：2016-04-01 00:00:00
abstract：BACKGROUND:Negative attitudes toward disability cause difficulties in integrating persons with disabilities (PWDs) into society and limit their access to health care, education, employment, and leisure. Being aware of societal attitudes toward disability may help explain discrimination against PWDs and draw attention t...
journal_title：Disability and health journal
pub_type： 杂志文章,评审
doi：10.1016/j.dhjo.2016.01.008
更新日期：2016-07-01 00:00:00
abstract：BACKGROUND:This study compared the expense associated with use of personal assistance services (PAS) for individuals with disabilities to the expense incurred by individuals with disabilities who did not use PAS. The intent of this investigation was to assess the disability accommodation costs and benefits of PAS and n...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2009.04.002
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND:Between 250,000 and 400,000 individuals in the United States are diagnosed with Down syndrome (DS). Nearly all adults with DS will develop Alzheimer's disease pathology starting in their thirties. Recent studies suggest that increased physical activity (PA) may be important for maintaining components of cogn...
journal_title：Disability and health journal
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.dhjo.2018.02.003
更新日期：2018-07-01 00:00:00
abstract：BACKGROUND:A substantial and increasing population of US women of childbearing age live with disability. Disability-based disparities in access to family planning services have been previously documented, but few studies have used population-based data sources or evidence-based measures of disability. OBJECTIVE:To det...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2017.03.014
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:Disability is not just a health problem. It is a wider phenomenon that reflects the gap between a person's capacities and their ability to fully perform the role demanded by society. Both personal and environmental factors are major contributors to disability. OBJECTIVE:We aimed to estimate the prevalence o...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2020.101043
更新日期：2020-11-19 00:00:00
abstract：BACKGROUND:Florida has the third largest population in the U.S. of persons living with disabilities, making optimizing health outcomes for this population paramount. Though the state has a long-standing and robust program to reduce tobacco use, prevention efforts do not specifically target persons with disabilities. O...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2013.01.008
更新日期：2013-07-01 00:00:00
abstract：:The concept of disability has medical, functional, and social components. We review the frameworks for the definition of disability and endorse a multidimensional approach that is parsimonious and has utility for epidemiology. We need to be able to count people with disabilities to quantify service and support needs, ...
journal_title：Disability and health journal
pub_type： 杂志文章,评审
doi：10.1016/j.dhjo.2010.06.002
更新日期：2011-01-01 00:00:00
abstract：BACKGROUND:Surveillance of trends in disability is necessary to determine the burden of disability on the U.S. military, the most common types of disability conditions, and the prevalence of combat exposures in the disability population. Previous studies of disability in the U.S. military have focused on a particular s...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2013.08.003
更新日期：2014-01-01 00:00:00
abstract：BACKGROUND:Many health conditions have been described in children with Down syndrome (DS). However, there are little comparative population-based data available. OBJECTIVE/HYPOTHESES:We sought to examine the health impacts associated with DS and other disabling conditions in U.S. children included in the 2005-2006 Nat...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2010.06.001
更新日期：2011-04-01 00:00:00
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journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2019.05.004
更新日期：2019-10-01 00:00:00
abstract：BACKGROUND:People with developmental disabilities are at disproportionately high risk of abuse. Although considerable evidence exists on the health-related consequences of abuse in the general population, little is known about those consequences in people with developmental disabilities. OBJECTIVE:To examine the relat...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2018.09.007
更新日期：2019-04-01 00:00:00
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journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2020.100908
更新日期：2020-07-01 00:00:00
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journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2020.100985
更新日期：2021-01-01 00:00:00
abstract：BACKGROUND:An overarching question in health policy concerns whether the current mix of public and private health coverage in the United States can be, in one way or another, expanded to include all persons as it does in Canada. As typically high-end consumers of health care services, people with disabilities are key s...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2008.07.006
更新日期：2008-10-01 00:00:00
abstract：BACKGROUND:Prescription opioid use among people with disabilities has not been well characterized. OBJECTIVE:To examine prescription opioid use, misuse, and use disorder, reason and source for last prescription opioid misuse, and receipt of prescription opioid treatment among people with and without disabilities. MET...
journal_title：Disability and health journal
pub_type： 杂志文章
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更新日期：2019-07-01 00:00:00
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journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2017.04.008
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:Medicaid is one of the most important health care safety nets for people with disabilities in the United States. Yet, from the beginning Medicaid only covered long-term services and supports (LTSS) through institutional care. In 1981 changes to Medicaid allowed states to provide home and community-based serv...
journal_title：Disability and health journal
pub_type： 杂志文章
doi：10.1016/j.dhjo.2019.01.012
更新日期：2019-07-01 00:00:00
