TY - JOUR
T1 - At the intersection of chronic disease, disability and health services research
T2 - A scoping literature review
AU - Gulley, Stephen P.
AU - Rasch, Elizabeth K.
AU - Bethell, Christina D.
AU - Carle, Adam C.
AU - Druss, Benjamin G.
AU - Houtrow, Amy J.
AU - Reichard, Amanda
AU - Chan, Leighton
N1 - Funding Information:
This research was supported by the NIH Intramural Research Program. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the National Institutes of Health, the United States government or the other institutions with which the authors are affiliated. The authors gratefully acknowledge the contributions of the other members of the ACHCN expert panel, including: Barbara Altman, Ph.D. (Disability statistics consultant, Rockville, MD), Stephen Blumberg, Ph.D., (CDC/NCHS) and Margaret Grace Stineman, MD, (Perelman School of Medicine, University of Pennsylvania).
Funding Information:
This research was supported by the NIH Intramural Research Program. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the National Institutes of Health, the United States government or the other institutions with which the authors are affiliated. The authors gratefully acknowledge the contributions of the other members of the ACHCN expert panel, including: Barbara Altman, Ph.D. (Disability statistics consultant, Rockville, MD), Stephen Blumberg, Ph.D., (CDC/NCHS) and Margaret Grace Stineman, MD, (Perelman School of Medicine, University of Pennsylvania).
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/4
Y1 - 2018/4
N2 - Background: There is a concerted effort underway to evaluate and reform our nation's approach to the health of people with ongoing or elevated needs for care, particularly persons with chronic conditions and/or disabilities. Objective: This literature review characterizes the current state of knowledge on the measurement of chronic disease and disability in population-based health services research on working age adults (age 18–64). Methods: Scoping review methods were used to scan the health services research literature published since the year 2000, including medline, psycINFO and manual searches. The guiding question was: “How are chronic conditions and disability defined and measured in studies of healthcare access, quality, utilization or cost?” Results: Fifty-five studies met the stated inclusion criteria. Chronic conditions were variously defined by brief lists of conditions, broader criteria-based lists, two or more (multiple) chronic conditions, or other constructs. Disability was generally assessed through ADLs/IADLs, functional limitations, activity limitations or program eligibility. A smaller subset of studies used information from both domains to identify a study population or to stratify it by subgroup. Conclusions: There remains a divide in this literature between studies that rely upon diagnostically-oriented measures and studies that instead rely on functional, activity or other constructs of disability to identify the population of interest. This leads to wide ranging differences in population prevalence and outcome estimates. However, there is also a growing effort to develop methods that account for the overlap between chronic disease and disability and to “segment” this heterogeneous population into policy or practice relevant subgroups.
AB - Background: There is a concerted effort underway to evaluate and reform our nation's approach to the health of people with ongoing or elevated needs for care, particularly persons with chronic conditions and/or disabilities. Objective: This literature review characterizes the current state of knowledge on the measurement of chronic disease and disability in population-based health services research on working age adults (age 18–64). Methods: Scoping review methods were used to scan the health services research literature published since the year 2000, including medline, psycINFO and manual searches. The guiding question was: “How are chronic conditions and disability defined and measured in studies of healthcare access, quality, utilization or cost?” Results: Fifty-five studies met the stated inclusion criteria. Chronic conditions were variously defined by brief lists of conditions, broader criteria-based lists, two or more (multiple) chronic conditions, or other constructs. Disability was generally assessed through ADLs/IADLs, functional limitations, activity limitations or program eligibility. A smaller subset of studies used information from both domains to identify a study population or to stratify it by subgroup. Conclusions: There remains a divide in this literature between studies that rely upon diagnostically-oriented measures and studies that instead rely on functional, activity or other constructs of disability to identify the population of interest. This leads to wide ranging differences in population prevalence and outcome estimates. However, there is also a growing effort to develop methods that account for the overlap between chronic disease and disability and to “segment” this heterogeneous population into policy or practice relevant subgroups.
KW - Chronic conditions
KW - Health service utilization
KW - Measurement
KW - People with disabilities
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U2 - 10.1016/j.dhjo.2017.12.012
DO - 10.1016/j.dhjo.2017.12.012
M3 - Review article
C2 - 29396271
AN - SCOPUS:85040776856
SN - 1936-6574
VL - 11
SP - 192
EP - 203
JO - Disability and Health Journal
JF - Disability and Health Journal
IS - 2
ER -