Barriers to Healthcare Access Scale for People with Physical Disabilities: Development, Validation and Use

Abstract

The study was designed to develop and validate a scale for measuring barriers to healthcare and to examine barriers in the case of people with physical disabilities. A 35-item scale with a four-factor structure was developed using principal component analysis, and the scale’s psychometric properties were examined using confirmatory factor analysis. The scale was administered to a sample of 402 people with a physical disability. Descriptive analysis and a chi-square test were performed to study the distribution of barriers across various sociodemographic characteristics. The scale identified four barriers: Health system, transportation and geographical, attitudinal and social and financial barriers. The Cronbach’s α was 0.976, indicating high reliability. The sample consisted of 57.2% men and 42.8% women. More than 90% reported facing barriers while accessing healthcare, but the financial barrier was significantly more. Increasing age and low levels of education were significantly associated with all four categories of barriers. Rural residence was associated with geographical and transportation barriers ( P value = 0.02), while working status was associated with the financial barrier ( P value = 0.03). Greater attention is needed to the financial and transport assistance for people with disabilities. The new tool, d-BAR, is contextual and valuable in identifying barriers to accessing healthcare among people with disabilities.