Unmasked by a Pandemic: Resolving Barriers to Inpatient Care For People with Disabilities-Slides

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This presentation, "Unmasked by a Pandemic: Identifying and Addressing Barriers to Care for People with Disabilities," by Tara Lagu, MD MPH, and Chris Moreland, MD MPH, explores the multifaceted challenges faced by people with disabilities (PWD) in healthcare, worsened by the COVID-19 pandemic. The study revealed significant physical access barriers—22% of surveyed practices were inaccessible, with few equipped with height-adjustable tables or lifts—leading to difficulties in accommodating disabled patients. Many medical providers lack knowledge of legal obligations under the Americans with Disabilities Act (ADA) and report limited confidence and training in caring for PWD, with some expressing discriminatory attitudes or avoiding new disabled patients altogether.<br /><br />Disparities in healthcare access and quality for PWD include higher rates of unmet medical needs, chronic diseases, and poorer social determinants of health. Legislative protections like the ADA mandate nondiscrimination and reasonable accommodations, yet implementation remains inconsistent. Barriers are physical (inaccessible facilities), communicative (lack of alternate communication methods), programmatic (inefficient scheduling), and attitudinal (bias and ableism). “Ableism” is highlighted as a systemic form of discrimination privileging able-bodied individuals.<br /><br />The authors emphasize that improving care requires more than just equipment upgrades; education of healthcare professionals, structural changes, and attitudinal shifts are critical. Focus groups with physicians revealed challenges such as insufficient time allocated for patients with disabilities, inadequate ADA knowledge, and frustration with systemic constraints. The healthcare workforce itself underrepresents disabled individuals, impacting care quality and language concordance, especially for deaf patients.<br /><br />Recommendations include: actively asking about accommodations, involving PWD in care decisions (“nothing about us without us”), enhancing disability-specific training and policies, improving accessibility of medical education, and fostering inclusivity within healthcare teams. The presentation calls for systemic reforms, increased research on quality care metrics for PWD, and expanding disability competency as a core aspect of medical practice.

Keywords

disabilities

healthcare access

COVID-19 pandemic

Americans with Disabilities Act

physical barriers

ableism

disability accommodations

medical education

health disparities

inclusive care