ACCESS TO PRIMARY HEALTH-CARE AMONG PERSONS WITH DISABILITIES IN RURAL-AREAS - A SUMMARY OF THE LITERATURE

Despite the prevalence of disabilities among persons living in rural a reas, scarce data exist on their health care needs. While rural reside nts generally experience barriers to access to primary health care, th ese problems are further exacerbated for people with disabilities. Thi s article summarizes findings from the published literature on access to primary health care among people with disabilities living in rural locations. A comprehensive computerized literature search turned up 86 articles meeting the study criteria, focused on the following rural p opulations affected by disabilities: children and adolescents, working -age adults, the elderly, the mentally ill, and people with AIDS. For each of these populations, substantial problems in accessing appropria te health cave have been documented. The literature consistently empha sizes the failure of local health care systems in nonmetropolitan area s to adequately address the complex medical and related needs of indiv iduals with disabilities. In the absence of specialized expertise, fac ilities, and primary care providers trained specifically to care for d isabled persons, local programs rely heavily on the use of indigenous paraprofessionals and alternative models of care. Further research is needed to identify and test the efficacy of innovative service deliver y strategies to improve health care access for this population.