At the intersection of chronic disease, disability and health services research: A scoping literature review.

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.

Introducing the Adults with Chronic Healthcare Needs (ACHCN) definition and screening instrument: Rationale, supporting evidence and testing.

Background: Among working age adults in the United States, there is a large, heterogeneous population that requires ongoing and elevated levels of healthcare and related services. At present, there are conflicting approaches to the definition and measurement of this population in health services research.

Objective: An expert panel was convened by the National Institutes of Health with the objective of developing a population-level definition of Adults with Chronic Healthcare Needs (ACHCN).

Diagnosis isn't enough: Understanding the connections between high health care utilization, chronic conditions and disabilities among U.S. working age adults.

Background: Under the ACA, new programs are being developed to enhance care coordination and reduce health care costs among people with chronic conditions, disabilities, and high utilization of health care. However, the relationships between these groups are not well understood.

Objectives: Our aims were to (1) identify high utilizers of health care in the U.

Difference, disparity, and disability: a comparison of health, insurance coverage, and health service use on the basis of race/ethnicity among US adults with disabilities, 2006-2008.

Background: In the United States, research on health disparities has begun to include people with disabilities as a minority population. However, there is a gap in our knowledge of whether, and to what extent, racial and ethnic disparities may affect the health or health care access of people with disabilities.

Objectives: We examined potential disparities in overall health, insurance coverage status, and health service use between non-Hispanic whites, non-Hispanic blacks, and Hispanics, among a nationally representative US sample of adults with and without disabilities (N=63,257), using both bivariate and multivariate methods.

Use of emergency departments among working age adults with disabilities: a problem of access and service needs.

Objective: To examine the relationship between emergency department (ED) use and access to medical care and prescription medications among working age Americans with disabilities.

Data Source: Pooled data from the 2006-2008 Medical Expenditure Panel Survey (MEPS), a U.S.

The complex web of health: relationships among chronic conditions, disability, and health services.

Objectives: A critical issue in health-care reform concerns how to realign health-care delivery systems to manage medical care services for people with ongoing and costly needs for care. We examined the overlapping health-care needs of two such population groups among the U.S.

If we build it, who will come? Working-age adults with chronic health care needs and the medical home.

Background: Currently, there is a call to implement and test the patient-centered medical home in adult populations, particularly among those with chronic conditions. However, the size, composition, and service use of the population who might require this coordinated care model need to be assessed, as does the way they are defined and identified.

Objectives: Using nationally representative data from the 2002 to 2004 Medical Expenditure Panel Survey, we provide a preliminary profile of the population of working-age adults with chronic health care needs (ACHCN), including those with chronic health conditions and disabilities.

Ongoing coverage for ongoing care: access, utilization, and out-of-pocket spending among uninsured working-aged adults with chronic health care needs.

Objectives: We sought to determine how part-year and full-year gaps in health insurance coverage affected working-aged persons with chronic health care needs.

Methods: We conducted multivariate analyses of the 2002-2004 Medical Expenditure Panel Survey to compare access, utilization, and out-of-pocket spending burden among key groups of persons with chronic conditions and disabilities. The results are generalizable to the US community-dwelling population aged 18 to 64 years.

Convergence and divergence: differences in disability prevalence estimates in the United States and Canada based on four health survey instruments.

An analysis of data from the Joint Canada/United States Survey of Health (JCUSH), allows us to compare prevalence estimates that result from four different question sets designed to assess disability from a group of respondents residing in either Canada or the United States. Depending upon the question set used and the coding applied to the responses, age-standardized prevalence estimates varied widely in both countries. In the U.

Disability in two health care systems: access, quality, satisfaction, and physician contacts among working-age Canadians and Americans with disabilities.

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 stakeholders to consider in this debate. The risk is that ways to cover more persons may be found only by sacrificing the quantity or quality of care on which people with disabilities so frequently depend.