Journal of Disability Policy Studies最新文献

英文中文

1915(c) Medicaid Waivers for Children With Severe Emotional Disturbance: Participant Characteristics, Enrollment, and Out-of-Home Service Use 1915（c）严重情绪障碍儿童的医疗补助豁免：参与者特征、注册和家庭外服务使用

IF 1.6 4区医学 Q3 REHABILITATION

Journal of Disability Policy Studies

Pub Date : 2023-03-08 DOI: 10.1177/10442073231157347

Genevieve Graaf, Emily A Whitfield, L. Snowden

Several states have invested in 1915(c) Home and Community Based Service (HCBS) Medicaid policies to improve outcomes and reduce costs for children and youth with significant behavioral health needs, or Severe Emotional Disturbance (SED). However, little is known about these programs and the children they serve. Through a retrospective cross-sectional analysis, this study aimed to understand if the program was successfully reaching its target population: children and youth with the highest clinical need, at the greatest risk for out-of-home care, and who may not otherwise be eligible for Medicaid through other avenues. Results describe the demographic, clinical, and service use characteristics of children and youth enrolled in one SED Waiver program, comparing them with those of similar, non-waiver enrolled children with behavioral health needs. Findings report that the waiver program examined rarely served children and families not otherwise eligible for Medicaid, but that waiver-enrolled children and youth had substantially more severe clinical need, were at higher risk for out-of-home placement and incurred greater public expenditures for service use. Findings suggest the program studied is serving children with more significant psychiatric needs, as the program intends, but points to the need for further research to understand the impacts of such programs on system and clinical outcomes.

一些州在1915年(c)家庭和社区服务(HCBS)医疗补助政策上进行了投资，以改善有重大行为健康需求或严重情绪障碍(SED)的儿童和青少年的结果并降低成本。然而，人们对这些项目和他们所服务的儿童知之甚少。通过回顾性横断面分析，本研究旨在了解该计划是否成功地覆盖了目标人群:具有最高临床需求的儿童和青少年，在户外护理的风险最大，并且可能没有资格通过其他途径获得医疗补助。结果描述了参加SED豁免项目的儿童和青少年的人口学、临床和服务使用特征，并将其与类似的、有行为健康需求的非豁免儿童进行了比较。研究结果表明，豁免计划很少为没有资格获得医疗补助的儿童和家庭提供服务，但豁免计划的儿童和青少年有更严重的临床需求，有更高的外出安置风险，并在服务使用方面产生更多的公共支出。研究结果表明，所研究的项目正在服务于有更重大精神需求的儿童，正如该项目所打算的那样，但指出需要进一步研究，以了解此类项目对系统和临床结果的影响。

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引用次数: 2

Variance in Autism Prevalence: Links With State-Level Autism Resources 自闭症患病率的差异：与州一级自闭症资源的联系

IF 1.6 4区医学 Q3 REHABILITATION

Journal of Disability Policy Studies

Pub Date : 2023-03-07 DOI: 10.1177/10442073231156940

Johanna S. Kester, Trenesha L Hill, Lauren Thompson, Corey L. Black, Veronica L. Coriano, Julia Bruton, Courtney N. Baker

The prevalence of autism spectrum disorder (ASD) has varied over time and across the United States. This variability is likely related to external factors, such as regional differences in ASD-related resources. The study reported on here examined the links between ASD prevalence as measured by Individuals with Disabilities Education Act (IDEA) Part B child count data and four aspects of state infrastructure (health care and insurance policies, clinical resources, research infrastructure, and awareness-raising individuals/organizations). This study also investigated whether these constructs varied by geographical region. The data for this study were abstracted from publicly available databases. Information on state infrastructure was gathered from high-quality reports, resource guides, certificant registries, and databases. More comprehensive ASD-relevant insurance and health care policies, more clinical resources, and greater research infrastructure were associated with higher ASD state prevalence rates as measured by the IDEA Part B child count data. Prevalence of ASD was higher in eastern U.S. states compared with southern U.S. states, but state-level ASD resources did not statistically significantly differ across geographic regions. Implications for research, practice, and policy are discussed.

自闭症谱系障碍（ASD）的患病率随着时间的推移和美国各地的不同而不同。这种可变性可能与外部因素有关，例如ASD相关资源的区域差异。本文报道的这项研究考察了《残疾人教育法》（IDEA）B部分儿童计数数据衡量的ASD患病率与国家基础设施的四个方面（医疗保健和保险政策、临床资源、研究基础设施和提高个人/组织意识）之间的联系。本研究还调查了这些结构是否因地理区域而异。这项研究的数据是从公开的数据库中提取的。有关国家基础设施的信息是从高质量的报告、资源指南、认证机构登记处和数据库中收集的。根据IDEA B部分儿童计数数据，更全面的ASD相关保险和医疗政策、更多的临床资源和更大的研究基础设施与更高的ASD州患病率相关。与美国南部各州相比，美国东部各州的ASD患病率更高，但州级ASD资源在不同地理区域的统计上没有显著差异。讨论了对研究、实践和政策的影响。

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引用次数: 0

Using Data Mining and Time Series to Investigate ME and CFS Naming Preferences 使用数据挖掘和时间序列研究ME和CFS命名偏好

IF 1.6 4区医学 Q3 REHABILITATION

Journal of Disability Policy Studies

Pub Date : 2023-02-24 DOI: 10.1177/10442073231154027

Shaun Bhatia, L. Jason

There have been numerous iterations of naming convention specified for Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS). As health care turns to “big data” analytics to gain insights, the Google Trends database was mined to ascertain worldwide trends of public interest in several ME- and CFS-related search categories between 2004 and 2019. Time series analysis revealed that though “Chronic Fatigue Syndrome” remains the predominant search category in the ME and CFS field, the interest index declined at a rate of 2.77 per month during the 15-year study period. In the same time period, the interest index in “ME/CFS Hybrid” terms increased at a rate of 3.20 per month. Potential causal mechanisms for these trends and implications for patient sentiment analysis are discussed.

针对肌痛性脑脊髓炎（ME）和慢性疲劳综合征（CFS），已经有过多次命名惯例的迭代。随着医疗保健转向“大数据”分析以获得见解，谷歌趋势数据库被挖掘出来，以确定2004年至2019年间公众对几个脑脊髓炎和慢性疲劳综合征相关搜索类别感兴趣的全球趋势。时间序列分析显示，尽管“慢性疲劳综合症”仍然是脑脊髓炎和慢性疲劳综合征领域的主要搜索类别，但在15年的研究期间，兴趣指数以每月2.77的速度下降。在同一时期，以“中小企业/粮安委混合”计算的利息指数以每月3.20的速度增长。讨论了这些趋势的潜在因果机制以及对患者情绪分析的影响。

引用次数: 0

Has Access to Paraprofessionals Changed? A Cross-Decade, Cross-Cohort Analysis 辅助专业人员的访问权限发生了变化吗？跨十年、跨队列分析

IF 1.6 4区医学 Q3 REHABILITATION

Journal of Disability Policy Studies

Pub Date : 2023-02-01 DOI: 10.1177/10442073221150611

Michael A. Gottfried, C. Ozuna

Due to shifts in society’s attitudes toward special education and changes in federal policies, such as Individuals with Disabilities Education Act and No Child Left Behind, more students with disabilities (SWDs) are beginning kindergarten in general education classrooms. As a result, schools and districts across the United States have needed to adjust their personnel resources to accommodate these changes to classroom demographics. This study aims to better understand how paraprofessional resources (i.e., availability and hours) have shifted before and after key federal legislation. We specifically examine the presence and hours worked by general and special education paraprofessionals in general education kindergartens. Using two nationally representative datasets from 1998 and 2010, we find that kindergartners with disabilities in 2010 have greater access to paraprofessionals (both general and special) in general education classrooms compared with children having disabilities from a decade earlier. Implications are discussed.

由于社会对特殊教育态度的转变和联邦政策的变化，如《残疾人教育法》和《不让一个孩子掉队》，越来越多的残疾学生开始在普通教育教室上幼儿园。因此，美国各地的学校和地区需要调整其人力资源，以适应课堂人口结构的这些变化。这项研究旨在更好地了解非专业资源（即可用性和工作时间）在关键的联邦立法前后是如何变化的。我们专门调查普通教育和特殊教育辅助专业人员在普通教育幼儿园的出勤情况和工作时间。使用1998年和2010年的两个具有全国代表性的数据集，我们发现，与十年前的残疾儿童相比，2010年的残疾幼儿园儿童在普通教育课堂上更容易接触到辅助专业人员（普通和特殊）。讨论了影响。

引用次数: 0

Disability Prevalence and Community-Level Allocation of Hurricane Harvey Federal Disaster Recovery Assistance in Texas 德克萨斯州哈维飓风联邦灾难恢复援助的残疾率和社区水平分配

IF 1.6 4区医学 Q3 REHABILITATION

Journal of Disability Policy Studies

Pub Date : 2023-01-29 DOI: 10.1177/10442073221150609

N. Malmin, D. Eisenman

Disasters have severe implications for life and property, often requiring large-scale collective action to facilitate recovery. One key determinant of recovery is access to resources that mitigate damage losses and shorten disaster recovery trajectories. However, communities with the disabiled present may be excluded from such services despite federal mandates for equal access and reasonable accommodations. We examined Hurricane Harvey federal recovery assistance distributions based on underlying community disability profiles. Through cross-sectional quantile regression, we used Federal Emergency Management Agency (FEMA) direct-to-household administrative data at the zip code level regressed onto American Community Survey estimates of disability. We found that as the prevalence of disability increased in communities, the total dollar amount of FEMA direct-to-household assistance decreased, controlling for factors such as storm damage, poverty, population density, and race/ethnicity. Moreover, disability-related funding disparities were driven primarily by hearing-related disabilities, with disparities in funding widening as total assistance increased in communities. Such inequities in community-level funding have implications on how well communities may recover from disasters.

灾害对生命和财产造成严重影响，往往需要大规模的集体行动来促进恢复。恢复的一个关键决定因素是能否获得减轻损害损失和缩短灾难恢复轨迹的资源。然而，有残疾人的社区可能会被排除在这些服务之外，尽管联邦规定了平等的机会和合理的便利。我们研究了基于潜在社区残疾概况的哈维飓风联邦恢复援助分配。通过横断面分位数回归，我们使用联邦紧急事务管理局(FEMA)直接到家庭的邮政编码水平的行政数据回归到美国社区调查对残疾的估计。我们发现，在控制了风暴破坏、贫困、人口密度和种族/民族等因素后，随着社区残疾患病率的增加，联邦应急管理局直接向家庭提供援助的总金额减少。此外，残疾相关的资金差距主要是由听力相关的残疾造成的，随着社区总援助的增加，资金差距也在扩大。社区一级资金的这种不平等影响到社区从灾难中恢复的程度。

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引用次数: 1

Opioid Use Among Social Security Disability Insurance Applicants, 2013–2018 2013-2018年社会保障残疾保险申请人阿片类药物使用情况

IF 1.6 4区医学 Q3 REHABILITATION

Journal of Disability Policy Studies

Pub Date : 2023-01-21 DOI: 10.1177/10442073221150613

Nicole Maestas, Tisamarie B. Sherry, Alexander Strand

Opioid use is common among Social Security Disability Insurance (SSDI) beneficiaries who account for a disproportionate share of opioid-related hospitalizations and mortality. However, little is known about the prevalence of opioid use prior to SSDI enrollment. Understanding when opioid use is established and how it correlates with individual characteristics and community prescribing practices would inform policy approaches to reducing opioid-related harms among SSDI beneficiaries. We estimated the prevalence of opioid use among SSDI applicants by applying a natural language processing algorithm to SSDI application data. We find the prevalence of opioid use among SSDI applicants declined from 33% in 2013 to 24% in 2018. In contrast, the share of applicants with musculoskeletal impairments, which are commonly associated with pain, was unchanged. The share of applications reporting opioid use declined across both sexes, all age groups and education levels, and all regions. There was substantial variation, however, in the magnitude of decline by geography, with the smallest declines in parts of the Midwest and Southeastern United States. SSDI application rates and applications reporting opioid use were more likely to come from communities with higher opioid prescribing rates. Our estimates suggest most SSDI beneficiaries began opioid use prior to entering the SSDI program.

阿片类药物使用在社会保障残疾保险(SSDI)受益人中很常见，他们在阿片类药物相关住院和死亡中所占比例过高。然而，在SSDI入组之前，对阿片类药物使用的流行程度知之甚少。了解阿片类药物的使用何时确定，以及它与个人特征和社区处方实践的关系，将为减少SSDI受益人中阿片类药物相关危害的政策方法提供信息。我们通过对SSDI申请数据应用自然语言处理算法来估计SSDI申请人中阿片类药物使用的流行程度。我们发现，SSDI申请人中阿片类药物的使用率从2013年的33%下降到2018年的24%。相比之下，肌肉骨骼损伤(通常与疼痛有关)的申请者比例没有变化。报告阿片类药物使用的申请比例在男女、所有年龄组和教育水平以及所有地区都有所下降。然而，不同地区的下降幅度有很大差异，美国中西部和东南部部分地区的下降幅度最小。SSDI申请率和报告阿片类药物使用的申请更有可能来自阿片类药物处方率较高的社区。我们的估计表明，大多数SSDI受益人在进入SSDI计划之前就开始使用阿片类药物。

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引用次数: 1

Systematic Review of Enrollment of Students With Disabilities in Charters Compared to Traditional Public Schools 与传统公立学校相比，特许学校招收残疾学生的系统评价

IF 1.6 4区医学 Q3 REHABILITATION

Journal of Disability Policy Studies

Pub Date : 2023-01-11 DOI: 10.1177/10442073221146567

Brenda K. Smith, Keith M. Christensen

There is a perception that charter schools enroll students with disabilities at a lower rate than traditional public schools, despite federal laws that require charter schools to provide the same services as traditional public schools. This systematic review answers the question: What research exists that explores the representation of students with disabilities in charter schools and the proportionality of that representation in comparison to traditional public schools? The methodology for this review was based on the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analyses) statement for reporting systematic reviews. Conclusions from this review include the limited amount of research on the topic, the difficulty of comparing enrollment percentages between state systems, and the difficulty in determining factors affecting the enrollment of students with disabilities in charter schools.

有一种看法认为，尽管联邦法律要求特许学校提供与传统公立学校相同的服务，但特许学校招收残疾学生的比例低于传统公立学校。这篇系统的综述回答了这样一个问题:有哪些研究探讨了特许学校中残疾学生的代表性，以及与传统公立学校相比，这种代表性的比例?本综述的方法基于报告系统评价的PRISMA(首选报告项目系统评价和荟萃分析)声明。从这篇综述中得出的结论包括:关于这一主题的研究数量有限，比较各州系统的入学率的难度，以及确定影响特许学校招收残疾学生的因素的难度。

引用次数: 0

On the Importance of the Americans with Disabilities Act at 30. 论《美国残疾人法》的重要性》，第 30 页。

IF 1.1 4区医学 Q3 REHABILITATION

Journal of Disability Policy Studies

Pub Date : 2023-01-01

Peter Blanck

This article offers a glimpse of the Americans with Disabilities Act ("ADA") of 1990, as amended by the ADA Amendments Act of 2008 ("ADAAA"), at its 30th anniversary. It considers current issues before the courts, primarily legal cases from 2020 and 2021, and new questions in light of the COVID-19 pandemic, such the latitude of the ADA's antidiscrimination protections and its definition of disability. It provides a quick primer on the basics of the ADA: employment discrimination under Title I, antidiscrimination mandates for state and local governments under Title II, and commands to places of accommodation offering services to the public under Title III. The ADA at 30 remains a beacon for a future in which all people, regardless of individual difference, will be welcomed as full and equal members of society.

本文介绍了经 2008 年《美国残疾人法修正案》（"ADAAA"）修订的 1990 年《美国残疾人法》（"ADA"）颁布 30 周年的情况。文章考虑了法院当前面临的问题，主要是 2020 年和 2021 年的法律案件，以及 COVID-19 大流行带来的新问题，如《美国残疾人法案》的反歧视保护范围及其对残疾的定义。本报告简要介绍了《反歧视法》的基本内容：第一章中的就业歧视、第二章中对州政府和地方政府的反歧视规定，以及第三章中对向公众提供服务的住宿场所的指令。美国残疾人机会均等法》颁布 30 周年之际，它仍然是一座灯塔，照亮着所有人，无论个体差异如何，都将作为完全平等的社会成员受到欢迎的未来。

引用次数: 0

Examining Differences in Self-Reported Health and Access to Health Care Among People With Early- and Late-Onset Disability 检查早期和晚期残疾患者自我报告健康状况和获得医疗保健的差异

IF 1.6 4区医学 Q3 REHABILITATION

Journal of Disability Policy Studies

Pub Date : 2022-12-08 DOI: 10.1177/10442073221142253

Kelsey S. Goddard, Jean P. Hall, Noelle K. Kurth

The purpose of the study is to compare self-reported health and access to health care among people with early- and late-onset disability. Adults with disabilities 18 to 62 years of age participated in the 2018 National Survey on Health and Disability (NSHD), which is a nationally representative, internet-based survey that provides data related to health insurance and access to health care. A subsample of participants who reported age at disability onset ( n = 1,188) completed measures related to demographics, health status, health insurance, and access to health care services. Results show that people with early-onset disability were significantly more likely to receive Supplemental Security Income (SSI; p < .001), less likely to receive Social Security Disability Insurance (SSDI; p < .001), more likely to have Medicaid ( p < .001), and less likely to have Medicare ( p < .01). People with late-onset disability were more likely to report service limitations and were more likely to report fair/poor health ( p < .001). Overall, study findings suggest that people with late-onset disability report higher out-of-pocket health care expenditures, greater access limitations, and poorer health. Medical professionals and disability service providers should be mindful about assisting this population in locating appropriate health insurance coverage, health services, and financial assistance.

这项研究的目的是比较早期和晚期残疾患者自我报告的健康状况和获得医疗保健的机会。18至62岁的残疾成年人参加了2018年全国健康与残疾调查（NSHD），这是一项具有全国代表性的基于互联网的调查，提供了与医疗保险和获得医疗保健相关的数据。报告残疾发病年龄的参与者的子样本（n=1188）完成了与人口统计、健康状况、健康保险和获得医疗保健服务相关的测量。结果显示，早发性残疾患者更有可能获得补充保障收入（SSI；p<.001），不太可能获得社会保障残疾保险（SSDI；p<0.001），更有可能获得医疗补助（p<.001，并且不太可能享受医疗保险（p<0.01）。晚发性残疾的人更有可能报告服务限制，更有可能报告健康状况尚可/较差（p<.001）。总体而言，研究结果表明，晚发性残疾人报告的自付医疗支出更高，获得服务的限制更大，健康状况较差。医疗专业人员和残疾服务提供者应注意帮助这一人群找到适当的医疗保险、医疗服务和财政援助。

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引用次数: 0

The Bangladeshi Rights and Protection of Persons With Disability Act of 2013: A Policy Analysis. 孟加拉国 2013 年《残疾人权利与保护法》：政策分析》。

IF 1.1 4区医学 Q3 REHABILITATION

Journal of Disability Policy Studies

Pub Date : 2022-12-01 Epub Date: 2021-12-29 DOI: 10.1177/10442073211066789

Reshma P Nuri, Heather M Aldersey, Setareh Ghahari, Ahmed S Huque, Jahan Shabnam

The government of Bangladesh enacted the Rights and Protection of Persons with Disability Act of 2013 (the Act) in line with the United Nations Convention on the Rights of Persons with Disabilities. This article sheds light on the Act with particular emphasis on (a) support offered to children with disabilities (CWDs) and their families to address their needs; and (b) the extent to which the Act is in line with the international disability policy analysis framework. We compared the Act with the 18 core concepts of disability policy developed by Turnbull et al. (2001). The results affirm the government's effort toward Sustainable Development Goals in providing support to CWDs and their families. They indicate a high degree of congruency of the Act with the core concepts. The findings also highlight the need to embrace the concepts of autonomy, confidentiality, and family-centeredness in great detail in any policy initiatives pertaining to CWDs. Furthermore, the finding shows that collaboration and coordination among ministries are imperative to achieve the goal of policies related to disability. In addition, the results highlight the need for more budgetary allocation and robust monitoring systems to track the progress of policy initiatives. As policy implementation is affected by changes in global contexts such as the coronavirus disease 2019 pandemic, policymakers in Bangladesh and other low- and middle-income countries should ensure that emergency responses are disability-inclusive and appropriate for CWDs. To ensure a disability-inclusive response, it is critical to engage individuals with disabilities and their families in meaningful consultations to identify their needs.

孟加拉国政府根据联合国《残疾人权利公约》颁布了 2013 年《残疾人权利与保护法》（以下简称《残疾人法》）。本文对该法进行了阐释，尤其侧重于：(a) 为残疾儿童及其家庭提供的支持，以满足他们的需求；(b) 该法在多大程度上符合国际残疾政策分析框架。我们将该法案与 Turnbull 等人（2001 年）制定的 18 个残疾政策核心概念进行了比较。结果肯定了政府在为社区福利残疾人及其家庭提供支持方面为实现可持续发展目标所做的努力。结果表明，该法案与核心理念高度一致。研究结果还强调，在任何与化武民工有关的政策措施中，都需要详细体现自主、保密和以家庭为中心的理念。此外，研究结果表明，各部委之间的合作与协调对于实现残疾相关政策的目标至关重要。此外，研究结果还突出表明，需要更多的预算拨款和强有力的监测系统来跟踪政策措施的进展情况。由于政策执行受到全球环境变化的影响，如 2019 年冠状病毒疾病大流行，孟加拉国和其他中低收入国家的政策制定者应确保应急措施兼顾残疾问题并适合化武疾病。为确保采取兼顾残疾问题的应对措施，必须让残疾人及其家人参与有意义的磋商，以确定他们的需求。

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