Policy Awareness, Financial Hardship, and Work Impact

Laurie A Drapela,Dana Lee Baker

doi:10.1177/2158244014553212

Laurie A Drapela, Dana Lee Baker

Open Access

https://doi.org/10.1177/2158244014553212

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Journal: SAGE Open	Publication Date: Jul 1, 2014
Citations: 25	License type: cc-by

Affiliation: Washington State University Vancouver

Abstract

Individuals with disabilities often report difficulty interacting with health care professionals. Addressing this challenge requires greater understanding of factors that exacerbate the odds of negative interactions between health care providers and patients with disabilities. Drawing on the qualitative research describing the features of such incidents, we use logistic regression to explore two dimensions of this dynamic: negative experiences with health care providers (e.g., doctors, specialists) and negative experiences with health insurance carriers (e.g., for profit or non-profit health insurance organizations). Using a non-probability sample of American families who have a child with autism spectrum disorder (ASD), we find that negative experiences with health care providers are associated with the family’s income level, as well as changes in parental labor force participation. The odds of a negative interaction with the insurance carrier are intensified when the family experiences financial difficulties and when they have a negative experience with the health care provider. Finally, families who are aware of laws and policies regarding ASD also report increased odds of negative experiences with their insurance carrier but not their health care provider. Policy implications of our findings are discussed.

Highlights

IntroductionPatients with autism spectrum disorder (ASD) can present unusual challenges for health care providers (Gurney, McPheeters, & Davis, 2006; Meyers & Johnson, 2007)
Providing Care for Individuals With autism spectrum disorder (ASD)Patients with ASD can present unusual challenges for health care providers (Gurney, McPheeters, & Davis, 2006; Meyers & Johnson, 2007)
More than half of our sample reported having a negative experience during the past year with their child’s health care provider, due to the child’s ASD (58%), and more than two thirds of respondents had a negative experience with their health insurance carrier, due to the child’s ASD (69%; Table 1). These differing percentages are consistent with our argument that families who are caring for a child with ASD make conceptual distinctions between their child’s health care provider and their health insurance carrier

Summary

Introduction

Patients with ASD can present unusual challenges for health care providers (Gurney, McPheeters, & Davis, 2006; Meyers & Johnson, 2007). The highly variable nature of this neurological difference among individuals can challenge physicians’ abilities to make an accurate diagnosis of the condition. Prognoses for children diagnosed with ASD are unreliable (Matson & Smith, 2008). The vast majority of children diagnosed with ASD became adults who, if not institutionalized, were almost certainly dependent on their families of origin and social welfare programs (Gray, 1993, 1994). While observed and expected improvement in overall outcomes for children with ASD is desirable, managing such uncertainty can complicate relationships between health care providers, health care insurers, and their families

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