Quality of care and role of health insurance among non-elderly women with disabilities

Womens Health Issues. Jul-Aug 2008;18(4):238-48. doi: 10.1016/j.whi.2008.02.005.


Objectives: We examined differences in the quality of health care provided by usual source of care providers between women with and without disabilities in the United States. The role of health insurance in ensuring equitable quality of care for women with disabilities was investigated.

Methods: A national sample of 12,199 women aged 18-64 was drawn from the 2002 Medical Expenditure Panel Survey. Descriptive and multivariate analyses were performed to investigate the interactive associations of disability and insurance coverage with accessibility, satisfaction and adequacy of care among women.

Results: Compared with women without disabilities, women with disabilities were more likely to experience lower quality of care in terms of accessibility of care, satisfaction with care, and adequate receipt of care. This diminished quality of care for women with disabilities was alleviated, but only to a limited extent, by health insurance coverage. A significant difference remained in the quality of care between the 2 insured subgroups.

Conclusions: Having health insurance was strongly associated with improved access to care and reduced unmet or delayed care among women with disabilities in the United States. In addition to an expansion of public insurance program eligibility, the quality of care provided under the public insurance system needs to be ensured to maximize appropriate and timely care for women with disabilities.

MeSH terms

  • Adult
  • Disabled Persons / statistics & numerical data*
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Insurance, Health / statistics & numerical data
  • Medically Uninsured / statistics & numerical data
  • Middle Aged
  • Quality of Health Care*
  • Quality of Life
  • United States / epidemiology
  • Women's Health Services / statistics & numerical data*
  • Women's Health*