Access to health care of persons with disabilities as an indicator of equity in health systems

Abstract

The outcomes of certain health services can be used to assess the overall effectiveness of a health care system. For example, maternal mortality is an indicator of the quality of a country?s maternal health services, which in turn reflects the overall functioning of the country?s health system.1 We propose that access by persons with disabilities to health care services, along with measures of disability, constitutes an indicator of overall equity in a health care system. Disability is defined here as activity limitation arising from any one of a variety of conditions, such as spinal cord injury, diabetes or HIV/AIDS, and it can constitute a significant barrier to accessing health care. Transport to health care facilities may be inaccessible to persons with disabilities, and the educational opportunities and social welfare supports available to such individuals may not be sufficient to enable them to properly access the health care they need. The ?system? that facilitates health for persons with disabilities thus reaches beyond the confines of health care facilities and the purview of health care professionals; indicators using this group of patients will therefore reflect the effectiveness of intersectoral and systemic contributors to equitable health care provision.