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BACKGROUND: Implementation issues often impede the realisation of the potential benefits of technology in disability care organisations for people with disabilities. Therefore, we conducted a longitudinal study to gain insights into the barriers and facilitators to implementation. METHODS: From 2019 to 2022, data were collected using questionnaires and interviews during 28 implementation projects in 26 disability care organisations. RESULTS: Barriers and facilitators were identified using 9 themes and 26 subthemes. The main themes identified were finances, disability care organisations, internal collaborations, external collaborations, technology, care staff, project teams, people with disabilities, and context. Most factors mentioned as barriers in one organisation were mentioned as facilitators in others. This suggests that barriers can be resolved to improve implementation. CONCLUSION: A large number of barriers and facilitators spanning the organisation suggests that the implementation of technology should be considered an organisational reform. Acting upon them is crucial for the successful implementation of technology.

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BACKGROUND: People with disabilities have numerous challenges in diabetes self-management. Poor self-management leads to the worsening of disability and secondary complications of diabetes. This study was conducted to explore the challenges in diabetes self-management and the factors influencing diabetes self-management among people with disabilities. METHODS: We conducted 16 case studies among people with physical, neurological, visual, hearing, and multiple disabilities who were affected by diabetes. We adopted a thematic content analysis approach to analyse the data. RESULTS: People with disabilities have challenges in adopting healthy diets as they are unable to purchase and consume fruits and vegetables which are costly, unavailable, and inaccessible. They have difficulty in doing physical activity due to lack of inclusive public spaces which are inaccessible, lack of motivation, and dependence on others for their mobility. Irregular drug supply in the public health system and unaffordable cost of drugs hamper adherence to medications. Laboratories are inaccessible to people with disabilities thus preventing monitoring of blood sugars. They have poor quality of life, life with pain and mental health issues, which prevent adoption of self-management behaviors. The intersectionality of age and gender with disability worsens self-management behaviors. Inaccessible health system, poor quality of health care and insensitive health care providers further complicate self-management. CONCLUSION: This study documents the challenges faced by persons with disabilities in practicing diabetes self management. There is a need for public health policy and planning that is inclusive of persons with disabilities to make access to diabetes care universal.

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Objective: To investigate temporal trends in mortality rates and underlying causes of death in persons with disabilities before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Annual mortality rates and causes of death were analyzed using data covering the 2017-2022 period. Results: The mortality rate among people with disabilities increased from 2017 to 2022; the rate was five times higher during COVID-19 in this population than in the general population. When analyzing the cause of death, the incidence of infectious diseases and tuberculosis decreased after COVID-19. In contrast, the incidence of other bacillary disorders (A30-A49) increased. The incidence of respiratory system diseases (J00-J99), influenza and pneumonia (J09-J18), and other acute lower respiratory infections (J20-J22) decreased before COVID-19, while the incidence of lung diseases due to external agents (J60-J70), other respiratory diseases principally affecting the interstitium (J80-J84), and other diseases of the pleura (J90-J94) increased during the pandemic. The risk of COVID-19 death among people with disabilities was 1.1-fold higher for female patients (95% CI = 1.06-1.142), 1.41-fold for patients aged 70 years and older (95% CI = 1.09-1.82), and 1.24-fold higher for people with severe disabilities (95% CI = 1.19-1.28). Conclusions: The mortality rate in people with disabilities significantly increased during COVID-19, compared with that before the pandemic. People with disabilities had a higher mortality rate during COVID-19 compared with the general population. Risk factors must be reduced to prevent high mortality rates in this population.

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Amid the global response to the COVID-19 pandemic, Cambodia emerges as a notable exemplar, boasting a remarkable vaccination rate of 91% of its population by the end of 2021. This success can be attributed to a multifaceted approach encompassing strong governmental leadership, robust vaccine management, and effective risk communication. Despite notable success, challenges persisted in reaching unvaccinated segments of the population. Rapid Coverage and Community assessments (RCCAs) supported by UNICEF were deployed in 2022 and 2023 to support Government efforts in expanding vaccination reach to missed populations and bolster COVID-19 booster doses. RCCAs were conducted across 8 provinces, assessing 13,547 individuals from 87 low-coverage communes to identify not vaccinated people and understand their barriers. Overall, only seven percent missed any dose of C-19 vaccine, Disabilities and lack of education correlated with higher rates of zero doses (20.8% and 17.8%, respectively), with concerns about personal health conditions (25%) and adverse effects (10%) cited as top reasons for non-vaccination. RCCAs, differing from routine monitoring, utilized purposive sampling to identify barriers to vaccine access and uptake. Findings informed adaptive strategies by government and partners to enhance outreach in low-coverage areas. The RCCAs played a crucial role at the local level in ensuring vaccinations reached overlooked populations, providing innovative solutions and supporting UNICEF's national strategies. By the end of 2022, Cambodia achieved a high subnational coverage, contributing to a national coverage of 95% for primary doses and nearly 70% for the first booster for everyone above three years old. RCCAs also fostered local coordination, facilitating resource sharing, and coordinated action for more effective local outreach and community trust. Integration of RCCAs into national immunization programs is recommended to develop targeted outreach for underserved populations, including zero-dose children and communities. Cambodia's adaptation of RCCAs during the pandemic offers valuable insights into identifying and engaging missed populations, highlighting the importance of community involvement and targeted interventions for future pandemic preparedness, and achieving more equitable health outcomes in the longer-term.

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Addressing the sexuality of individuals with disabilities is important within the framework of global health and societal inclusivity. Despite comprising 16% of the world's population, this demographic faces sexual autonomy inequality. Acknowledging this intersection is pertinent for achieving inclusive healthcare and upholding the commitments of the 1994 International Conference on Population and Development and the 2006 United Nations Convention on the Rights of Persons with Disabilities. Dispelling stereotypes and promoting dialogue are key to empowering individuals with disabilities and ensuring equitable access to sexual health resources. Integrating sexual health and rights into broader healthcare systems is vital for creating an inclusive society where no one is left behind. This article advocates for the need to address the specific sexual health needs and rights of individuals with disabilities, to implement inclusive policies, and to foster a healthcare environment that respects and supports their autonomy and dignity.

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The present text presents partial results of the research "Young people with disability due to gunshot wounds: an exploratory study from the Memorialistic Narratives", which aimed to problematize the effects of violence and criminality in the juvenile sphere by investigating, beyond the increase in mortality and incarceration rates, the transformation of these young people into people with disabilities, specifically, people in wheelchairs. To achieve this goal, we used as a method the Memorialistic Narratives and worked on the categories of exclusion, violence and a body marked by trauma. We will reflect on the case of Guilherme, a poor, marginalized young man with a disability and a wheelchair user due to a gunshot wound. The choice for his case relates to the different forms that violence can assume, influencing lives and leaving marks, besides, we believe that his life story can contribute to qualifying psychology's look at young people in contexts of violence.

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PURPOSE: To explore literature, policies or procedures available to care providers on how to deliver CPR and BLS to people with a disability, for whom the current standard guidelines are not fit for purpose. MATERIAL AND METHODS: A scoping review was conducted using four databases, namely, CINHAL, PubMed, Scopus, Medline and Google Scholar. Keywords used included, disab*, wheelchairs, cardiopulmonary, resuscitation, "basic life support", life support care, and bystander CPR. 1119 papers were retrieved and 1043 were screened following removal of 76 for duplication. 18 full text articles were reviewed and 5 met the inclusion criteria. RESULTS: The five articles were from three counties and included one case study, three expert opinion papers and one intervention study. Four of the papers advocated in favour of improved CPR and BLS guidelines and three of the papers discussed techniques and ideas for supplementation of standard CPR and BLS. CONCLUSION: The scoping review has uncovered a paucity of evidence explaining delivery of CPR and BLS for people with disability and highlights the need for further research. In the absence of further evidence, it is reasonable for educators to provide ideas and discussion about supplementing CPR and BLS for people with disability to carers.

People with disability and wheelchair users are at a high risk for premature or preventable deaths.Improved first aid responses are proposed to be a mitigating factor for premature and preventable deaths.Improved first aid responses will afford people with disability and wheelchair users the same opportunities for care and rehabilitation as people without disability.Formal and informal carers do not currently have prescriptive guidelines to improve their knowledge on responding to emergency events for people with disabilities.Development of improved guidelines is recommended to reduce fear and anxiety for formal and informal carers whilst also increasing their confidence to respond to emergency situations.

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There is a growing debate among scholars regarding the impact of artificial intelligence (AI) on the employment opportunities and professional development of people with disability. Although there has been an increasing body of empirical research on the topic, it has generally yielded conflicting findings. This study contributes to the ongoing debate by examining the linear and nonlinear effects of AI on the unemployment of people with disability in 40 countries between 2007 and 2021. Using the system Generalized Methods of Moments and panel smooth transition regression, the main conclusions are as follows. First, AI reduces the unemployment of people with disability in the full sample. Second, upon disaggregating the sample based on income level (high income/non-high income) and gender (men/women), the linear model only detects an inverse correlation between AI and unemployment among people with disability in high-income countries and among men, whereas it does not influence unemployment in non-high-income countries and women. Third, the panel smooth transition regression model suggests that the effects of AI on the unemployment of people with disability and among women are only observed once artificial intelligence interest search exceeds a specific threshold level. The effects of AI in non-high-income economies and among women are not significant in the lower regime, which confirms the nonlinear association between AI and the unemployment rate of people with disability. These findings have important policy implications for facilitating the integration of people with disability into the labor market.

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BACKGROUND: The Centers for Disease Control and Prevention (CDC) funds a quality improvement (QI) health promotion telewellness program for adults with physical disabilities. OBJECTIVE: The nutrition component of the parent program, Mindfulness, Exercise, and Nutrition to Optimize Resilience (MENTOR) program, from 2020 to 2021, was evaluated to assess changes in nutrition knowledge of people with physical disabilities. METHODS: This was a quasi-experimental program evaluation by pre-post survey of participating adults with physical disabilities. Participants attended weekly nutrition classes for eight weeks with optional one-on-one counseling with a Registered Dietitian. Participants completed pre-post General Nutrition Knowledge Questionnaire Revised (GNKQ-R) that were analyzed using paired t-tests. Participants were grouped into quartiles by pre-program GNKQ-R scores for additional comparisons. Program attendance and post-program feedback were also evaluated. RESULTS: A total of 286 participants completed the MENTOR program, and 31% (n = 89) completed pre-post questionnaires for data analysis. Mean pre-program GNKQ-R scores were 58.4 ± 15.1 and post scores were 64.4 ± 11.3, which demonstrated a statistically significant improvement in nutrition knowledge (p < .001). Ancillary analysis revealed that participants with the lowest quartile of pre-program nutrition knowledge had the greatest improvements in their post-GNKQ-R scores (Mean change 16.4 ± 13.9). Questionnaire data revealed participants' subjective knowledge changes and their feedback on the nutrition component of the program. CONCLUSIONS: The eight-week MENTOR program effectively improved nutrition knowledge among people with physical disabilities. This demonstrates the impact the program can have on individual knowledge levels. Additionally, these results support the implementation of the program to the broader population of people with disabilities.

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OBJECTIVES: There is substantial research on contributing factors to adverse events (AEs) in acute settings. Little is known about AEs in long-term care facilities (LTCFs). Our aim was to identify contributing factors to AEs from LTCFs for older persons and people with disability to inform quality improvement. DESIGN: Content analysis of statutory notifications of AEs from LTCFs using a modified version of the Human Factors Analysis and Classifications System (HFACS) applied to health care. SETTING: A sample of high risk-rated notifications of AEs received by the regulator in 2018 and 2019 was drawn from the Database of Statutory Notifications from Social Care in Ireland (n = 156). METHODS: Two researchers independently analyzed notifications to identify contributing factors using our modified HFACS. The number of factors identified in each level, subcategory, and nanocode of the HFACS was calculated along with percentage representation of factors within notifications and percentage contribution of individual factors to the total number of factors identified. The number and percentage contributions of factors were also calculated, disaggregated by notification type. RESULTS: Contributing factors from all levels of the HFACS were identified. The most common contributing factor was "Resident factors" followed by "Unsafe acts." No contributing factors were attributed to 68 notifications (43.6%). Multiple contributing factors were attributed to 45 notifications (28.8%). The largest percentage of factors was identified in notifications of serious injuries (27.4%). CONCLUSION AND IMPLICATIONS: It is the responsibility of LTCFs to account for "Resident factors" in system design, risk management, and care plans. Developing systems and processes that identify where residents have higher risk of harm may reduce the occurrence of high-risk events and thus improve resident safety. The large proportion of notifications where no contributing factors were identified suggests the need for improved reflection and reporting from LTCFs and for more specific questions on notification forms.

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Avaliamos, em conjunto com profissionais dos serviços, os desafios à implementação do modelo biopsicossocial nos Centros Especializados em Reabilitação. Por meio da articulação da Avaliação de Quarta Geração e Roda de Conversa (Método Paideia), abordamos os modelos implementados de assistência à pessoa com deficiência, partindo das seguintes questões: trabalhar em reabilitação; prontuário e avaliação; atendimento compartilhado e qualificação da alta. Do conteúdo das rodas emergiram três categorias empíricas: o processo de trabalho em reabilitação; o trabalho em rede; o modelo de cuidado. A identificação de entraves e facilitadores poderá favorecer a plena implementação do modelo biopsicossocial na atenção às pessoas com deficiência, gerando subsídios para o avanço rumo à integralidade do cuidado às pessoas com deficiência representado neste modelo.(AU)

We assessed challenges in implementing the biopsychosocial model in specialized rehabilitation centers together with the professionals working in these services. Using fourth generation assessment and conversation circles (the Paideia method), we explored models of care for people with disabilities focusing on the following issues: working in rehabilitation; health records and evaluation; shared appointments; and improving discharge. Three empirical categories emerged from the conversation circles: rehabilitation work processes; the network-based approach; and the care model. The identification of constraints and enabling factors can help promote the effective implementation of the biopsychosocial model, generating important insights to help drive progress towards the delivery of comprehensive care to people with disabilities represented in this model.(AU)

Evaluamos en conjunto con profesionales de los servicios, los desafíos para la implementación del modelo biosicosocial en los centros especializados en rehabilitación. Por medio de la articulación de la Evaluación de Cuarta Generación y Rueda de Conversación (Método Paideia), abordamos los modelos implementados de asistencia a la persona con discapacidad, partiendo de las siguientes cuestiones: trabajar en rehabilitación; historial médico y evaluación; atención compartida y calificación del alta. Del contenido de las ruedas surgieron tres categorías empíricas: el proceso de trabajo en rehabilitación; el proceso en red; el modelo de cuidado. La identificación de obstáculos y facilitadores podrá favorecer la plena implementación del modelo biosicosocial en la atención a las personas con discapacidad, generando subsidios para el avance hacia la integralidad del cuidado a las personas con discapacidad representado en este modelo.(AU)

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ABSTRACT Objectives: to identify and synthesize, from the literature, the impacts of physical disability caused by leprosy on the quality of life of individuals receiving care within the Health Care Network. Methods: this is a scoping review conducted following the JBI recommendations. The databases used in the search included the Medical Literature Analysis and Retrieval System Online, Cochrane Library, Web of Science, Lilacs, Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Leprosy Information Services, and Google Scholar. Results: 1690 documents were identified, of which 36 were included in the review. Physical disability caused by leprosy affects the quality of life in the areas of daily activities, socioeconomic aspects, psychological well-being, pain, and overall well-being. Conclusions: we identified the impairments caused by physical disability in the quality of life, highlighting the need for prevention, promotion, and rehabilitation actions, such as screening, case management, and health education.

RESUMEN Objetivos: identificar y sintetizar, a partir de la literatura, los impactos de la discapacidad física causada por la lepra en la calidad de vida de los individuos atendidos en la Red de Atención a la Salud. Métodos: se trata de una revisión de alcance, realizada de acuerdo con las recomendaciones del JBI. Las bases de datos utilizadas en la búsqueda fueron el Sistema de Análisis y Recuperación de Literatura Médica en Línea, la Biblioteca Cochrane, Web of Science, Lilacs, el Índice Cumulativo de Literatura en Enfermería y Ciencias Afines, Scopus, Embase, Leprosy Information Services y Google Scholar. Resultados: se identificaron 1690 documentos, de los cuales 36 fueron parte de la revisión. La discapacidad física causada por la lepra afecta la calidad de vida en términos de actividades de la vida diaria, socioeconómicas, psicológicas, dolor y bienestar general. Conclusiones: se identificaron los compromisos causados por la discapacidad física en la calidad de vida, indicando la necesidad de acciones de prevención, promoción y rehabilitación, como el seguimiento, el acompañamiento de los casos y la educación en salud.

RESUMO Objetivos: identificar e sintetizar, a partir da literatura, os impactos da incapacidade física causada pela hanseníase na qualidade de vida dos indivíduos atendidos na Rede de Atenção à Saúde. Métodos: trata-se de uma revisão de escopo, realizada de acordo com as recomendações do JBI. As bases de dados utilizadas na busca foram Medical Literature Analysis and Retrieval System Online, Cochrane library, Web of Science, Lilacs, Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Leprosy Information Services e Google Scholar. Resultados: foram identificados 1690 documentos, dos quais 36 compuseram a revisão. A incapacidade física causada pela hanseníase impacta na qualidade de vida no âmbito de atividades de vida diária, socioeconômico, psicológico, da dor e no bem-estar geral. Conclusões: foram identificados os comprometimentos causados pela incapacidade física na qualidade de vida, indicando a necessidade de ações de prevenção, promoção e reabilitação, como rastreamento, acompanhamento dos casos e educação em saúde.

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BACKGROUND: Despite growing recognition of essential human rights, people with mental health conditions and psychosocial, intellectual, or cognitive disabilities' rights are known to be frequently violated in mental healthcare worldwide, with common use of coercive practices and limited recognition of people's right to exercise their legal capacity and make decisions for themselves on treatment and other issues affecting them. To tackle this issue, Ghana adopted the WHO QualityRights Initiative in 2019. This aims to introduce a right-based, person-centred recovery approach within the mental health care system, protecting and promoting the rights of people with mental health conditions, psychosocial, cognitive, and intellectual disabilities in the healthcare context and community. METHODS: E-training (capacity-building) was provided in Ghana across a broad array of stakeholder groups including healthcare professionals, carers, and people with lived experience. The training covered legal capacity, coercion, community inclusion, recovery approach, service environment, and the negative attitudes commonly held by stakeholder groups; it was completed by 17,000 people in Ghana as of December 2021. We assessed the impact of the e-training on attitudes through comparing trainees' pre- and post-questionnaire responses on 17 items, each measured on a 5-point Likert scale (strongly disagree to strongly agree), such that higher scores indicated negative attitudes towards persons with mental health conditions and psychosocial disabilities as rights holders. Analyses were conducted on two main groups: matched pairs (417 pairs of baseline and follow-up questionnaire responses matched to a high degree of certainty), and the unmatched group (4299 individual completed questionnaire responses). RESULTS: We assessed the impact of the WHO QualityRights e-training on attitudes: training resulted in highly significant attitude changes towards alignment with human rights, with scores changing by approximately 40% between baseline and follow-up. In particular, attitude changes were seen in items representing treatment choice, legal capacity, and coercion. This change was not affected by age, gender, or background experience. CONCLUSIONS: The QualityRights e-training programme is effective in changing people's (especially healthcare professionals') attitudes towards people with mental health conditions and psychosocial, intellectual, or cognitive disabilities: this is a step towards mental healthcare being more with human rights-based worldwide.

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The aim of this research is to examine the effect of subjective health on the quality of life of Korean people with disabilities. The second goal of this study is to examine the effect of the Engel coefficient on quality of life. Additionally, this study is conducted to inspect the effect of employment and personal assets on quality of life. Further, in this work, the moderating effect of personal assets on the association between employment and quality of life for people with a disability is explored. The Panel Survey of Employment for the Disabled served as the source of data. The study period ranges from 2016 to 2018. To test the research hypotheses, this study adopted econometric analyses, namely, ordinary least squares, fixed effect, and random effect models. The results revealed that the quality of life for people with disabilities is positively influenced by subjective health, employment, and personal assets. In contrast, the Engel coefficient exerts a negative impact on quality of life. Plus, the finding indicates that personal assets negatively moderate the relationship between employment and quality of life for people with disabilities. This research is aimed at presenting policy implications for the welfare of people with disabilities.

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BACKGROUND: As digital health services advance, digital health equity has become a significant concern. However, people with disability and older adults still face health management limitations, particularly in the COVID-19 pandemic. An essential area of investigation is proposing a patient-centered design strategy that uses patient-generated health data (PGHD) to facilitate optimal communication with caregivers and health care service providers. OBJECTIVE: This study aims to conceptualize, develop, and validate a digitally integrated health care service platform for people with disability, caregivers, and health care professionals, using Internet of Things devices and PGHD to contribute to improving digital health equity. METHODS: The methodology consists of 5 stages. First, a collaborative review of the previous app, Daily Healthcare 1.0, was conducted with individuals with disabilities, caregivers, and health care professionals. Secondly, user needs were identified via personas, scenarios, and user interface sketches to shape a user-centered service design. The third stage created an enhanced app that integrated these specifications. In the fourth stage, heuristic evaluations by clinical and app experts paved the way for Daily Healthcare 2.0, now featuring Internet of Things device integration. Conclusively, in the fifth stage, an extensive 2-month usability evaluation was executed with user groups comprising individuals with disabilities using the app and their caregivers. RESULTS: Among the participants, "disability welfare information and related institutional linkage" was the highest priority. Three of the 14 user interface sketches the participants created were related to "providing educational content." The 11 heuristic evaluation experts identified "focusing on a single task" as a crucial issue and advocated redesigning the home menu to simplify it and integrate detailed menus. Subsequently, the app Daily Healthcare 2.0 was developed, incorporating wearable devices for collecting PGHD and connecting individuals with disabilities, caregivers, and health care professionals. After the 2-month usability evaluation with 27 participants, all participants showed an increase in eHealth literacy, particularly those who used the caregiver app. Relatively older users demonstrated improved scores in health IT usability and smartphone self-efficacy. All users' satisfaction and willingness to recommend increased, although their willingness to pay decreased. CONCLUSIONS: In this study, we underscore the significance of incorporating the distinct needs of individuals with disabilities, caregivers, and health care professionals from the design phase of a digital health care service, highlighting its potential to advance digital health equity. Our findings also elucidate the potential benefits of fostering partnerships between health consumers and providers, thereby attenuating the vulnerability of marginalized groups, even amid crises such as the COVID-19 pandemic. Emphasizing this imperative, we advocate for sustained endeavors to bolster the digital literacy of individuals with disabilities and champion collaborative cocreation, aiming to uphold the collective ethos of health and digital health equity.

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PURPOSE: Emergency and disaster management planning is an emerging role with limited practical guidance on how it should be implemented by community, disability, health and rehabilitation service providers. This study examined the emergency preparedness of service providers and how they viewed their role and contributions to disaster risk reduction, including their capacity and willingness to facilitate preparedness planning with their clients. MATERIALS AND METHODS: A questionnaire was developed and administered nationally. Descriptive statistics, multivariate regression analyses, and thematic analysis of open-ended questions provide insight on the knowledge, tools and training needs of service providers to contribute to preparedness of themselves and the people they support. RESULTS: Facilitating emergency preparedness with people with disability was strongly associated with a high level of mental preparedness, household preparedness scores, and completion of Person-Centred Emergency Preparedness (P-CEP) training. Perceived lack of funding, insufficient tools, and exclusion of emergency planning from job descriptions were negatively associated with facilitating emergency preparedness with clients. CONCLUSIONS: Study findings lay the groundwork for development of the role and capabilities of individual service providers including the need to equip disability, health and rehabilitation service providers with training and tools to prepare themselves and the people they support for emergencies.

Participation in emergency training such as psychological first aid, evacuation drills, and Person-Centred Emergency Preparedness (P-CEP) can increase the personal preparedness of service providers.Rehabilitation professionals are advised to develop their capabilities in emergency preparedness before facilitating emergency planning with their clients.Rehabilitation professionals should connect with their local emergency services to learn about disaster risks and preparedness actions they can take to increase personal emergency preparedness for themselves and their clients.

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BACKGROUND: Pulmonary infection (PI) and urinary tract infection (UTI) have been the most common cause of hospitalization and most frequent infection respectively in older people with disability (OPWD). Long-term care insurance (LTCI) policy, intending to provide services to reduce the disease burden of OPWD, it remains unclear whether LTCI could reduce PI-, and UTI-related hospitalizations. This quasi-experimental study aimed to assess the influences of LTCI on all-cause, especially PI- and UTI-related hospitalizations among OPWD and the variation across sociodemographic characteristics. METHODS: 32,120 participants in the Chengdu Long-term Care Insurance cohort were considered the intervention group, and 2,704 not covered by the LTCI were in the control group. A total of 3,134,160 hospitalization records were collected between January 2014 and June 2021. A doubly robust difference-in-differences (DID) method was used to estimate the average treatment effect on the treated (ATT), indicating the average effect of LTCI on intervention group. RESULTS: The average monthly all-cause, PI-, and UTI-related hospitalization rates were 16.3%, 4.0% and 0.5% in the intervention group, respectively, and were 19.3%, 3.9% and 0.5% in the control group, respectively. Under LTCI, all-cause (ATT [95% CI]: 7.15% [6.41%, 7.88%]), PI- (3.25% [2.76%, 3.74%]), and UTI-related hospitalizations (0.46% [0.28%, 0.64%]) were decreased. The influences of LTCI became significant after 5 months since the LTCI implementation and remained stable over time. The impact was more pronounced among those with longer coverage. The overall reduction was stronger in those who were not married, lived alone, and resided in institutions. CONCLUSIONS: LTCI may reduce the occurrence of all-cause, PI-, and UTI-related hospitalizations in OPWD, with stronger influences observed over an extended period of implementation. The implementation of LTCI can play a role in reducing the burden of infectious diseases in OPWD and the care burden of families and society.

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OBJECTIVE: Previous studies had demonstrated that disability increases mortality in patients with coronary heart disease (CHD). However, for people who had been disabled but do not have baseline cardiovascular disease, there is still limited data on how they might develop CHD. This study aimed to investigate the incidence and predictors of CHD in people with disabilities. METHODS: We conducted a 7-year retrospective study utilizing data from the Shanghai Comprehensive Information Platform for Persons with Disabilities Rehabilitation. Subjects aged over 18 years with at least four annual complete electronic health records were included. The primary outcome was CHD, defined as ischemic heart disease or myocardial infarction. Kaplan-Meier analysis and log-rank tests were used to compare cumulative CHD for sub-populations, stratified by age, gender, and the classification of disabilities. Cox regression was used to identify the potentially important factors. RESULTS: Out of 6419 persons with disabilities, 688 CHD cases (mean age 52.95 ± 7.17 years, male 52.2%) were identified, with a cumulative incidence of 10.72% and an incidence density of 15.15/1000 person-years. The incidence density of CHD is higher in the male gender, people over 45 years, and those with physical disabilities. Male (HR = 1.294, 95% CI, 1.111-1.506), hypertension (HR = 1.683, 95% CI, 1.405-2.009), diabetes mellitus (HR = 1.488, 95% CI, 1.140-1.934), total cholesterol (HR = 1.110, 95% CI, 1.023-1.204), and physical disabilities (HR = 1.122, 95% CI, 1.019-1.414) were independently associated with CHD. CONCLUSION: The findings indicate that the incidence of CHD differs across disability categories rather than the severity of disability. People with physical disabilities had significantly higher risks for the development of CHD. The underlying physiological and pathological factors need to be further studied.

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In Peru, Venezuelan migrants and refugees have been exposed to food shortages before their emigration. This problem could have worse outcomes in vulnerable populations (such as people with disabilities); however, the literature on the basic needs of this population is still scarce. The objective was to determine the association between the presence of disability and the unmet need for access to food in the household of the Venezuelan migrant and refugee population residing in Peru. A cross-sectional study was conducted using data from the Second Survey of the Venezuelan Population Residing in Peru (ENPOVE 2022). The outcome variable was unmet need for food, while the independent variable was the presence of disability. Poisson log generalized linear regression models (crude and adjusted for potential confounding variables) were fitted to evaluate the association between the variables of interest, reporting prevalence ratios (PR) and 95% confidence intervals (CIs). A total of 7739 migrants and refugees from Venezuela were included. The proportion of unmet need for access to food in the household was 45.2%, while the proportion of disability was 2.1%. People with disabilities were found to be more likely to have an unmet need for access to food at home (adjusted PR [aPR]: 1.25; 95% CI: 1.08-1.46; p = 0.003). According to our findings, almost half of Venezuelan households were found to have an unmet need for access to food. In addition, Venezuelan migrants and refugees with disabilities were more likely to have an unmet need for this basic need.

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BACKGROUND: People with disabilities (PWDs) have unequal access to health services compared with the general population and this disparity is worsening during the Covid-19 pandemic. Evidence supports the importance of policy development and legislation for addressing the unmet health needs of PWDs, but little is known about the impact of these efforts in Ghana. OBJECTIVE: This study examined health system experiences of PWDs in Ghana within the context of existing disability legislation and related policies prior to and during the Covid-19 pandemic. METHODS: Narrative analysis of data from qualitative research approaches of focus group discussions, semi-structured interviews, and participant observations were used to examine the experiences of fifty-five PWDs, four staff of the Department of Social Welfare, and six leaders of disability-focused non-governmental organizations in Ghana. RESULTS: Structural and system barriers hinder PWDs access to health services. Bureaucratic bottlenecks hinder PWDs access to Ghana's free health insurance policy and health workers' disability stigma impedes accessibility to health services. CONCLUSIONS: Access barriers and disability stigma increased accessibility challenges for PWDs in Ghana's health system during the Covid-19 pandemic. My findings support the need for increased efforts toward making Ghana's health system more accessible to address health disparities experienced by PWDs.

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