Access to healthcare for people with intellectual disability: a scoping review.

Abstract

Aims: People with intellectual disability experience stark health inequalities, often because of poor access to mainstream healthcare. This scoping review aimed to identify factors that influence access to healthcare for people with intellectual disability using Levesque and colleagues' comprehensive framework of healthcare access.

Method: This review followed Joanna Briggs Institute guidelines. Articles were identified and retrieved from CINAHL, PsycINFO, PubMed and EMBASE. Two reviewers completed abstract and full-text screening, addressing any conflicts at each stage. Data was extracted and coded deductively, according to the supply (healthcare provider) and demand (healthcare seeker) dimensions of Levesque and colleagues' framework.

Results: Following search and screening, 66 references were included for review. Barriers to healthcare were more frequently identified in the literature compared to facilitators, with most information relating to supply-side dimensions. Barriers were related to inaccessible health information, low health literacy, stigma and discrimination by healthcare providers, and lack of organisational support, training and resourcing in both healthcare and support sectors. Facilitators often involved specialist workforces, strong interpersonal skills among healthcare providers, and advocacy from supporters. Importantly, findings indicated that both sociohistorical processes and support networks are necessary to understanding access experiences for people with intellectual disability.

Conclusions: Greater efforts are required internationally to ensure the health rights of people with intellectual disability, to eliminate discrimination, and provide the support and resources necessary for all stakeholders to facilitate healthcare access. Models of healthcare access for people with intellectual disability should consider both the role of supporters and the sociohistorical context within which healthcare access occurs.