Cost burden of social isolation for wheelchair users in Louisville, Kentucky.

disability policy;wheelchair users;QALY;social determinants of health;visitability;housing policy;built environment

Connie Light

University:University of Louisville

Department:Health Management and Systems Sciences

关键词: disability policy;    wheelchair users;    QALY;    social determinants of health;    visitability;    housing policy;    built environment;   

Others  :  https://ir.library.louisville.edu/cgi/viewcontent.cgi?article=4058&context=etd

美国|英语

来源: The Universite of Louisville's Institutional Repository

【 摘 要 】

Background: Social isolation is an important predictor for poor health status, chronic diseases, and healthcare utilization and costs. There is a growing number of Americans with one or more disabilities, and evidence suggests that many are also socially isolated. This is especially true for those with immobility, as the built environment including housing structures are not universally designed to be accommodating. Immobility describes those who use walkers, canes, or wheelchairs, with the latter suffering the most impact. The cost of social exclusion can be measured by the exacerbation of disease in wheelchair users, whose fragile health status and social networks are interrelated. Methods: This study estimates the additional cost of healthcare utilization of wheelchair users in Louisville, Kentucky due to social isolation based on assumptions gained from evidence-based literature and compares that cost to the estimated cost of adding visitability features to newly constructed housing units. This study assumes that visitability policy had been enacted in Louisville, Kentucky in 2004 at an average cost to contractors and owners of $500. As a result, 34,120 single family, duplex homes and half of all multiplex units built between the years 2004 and 2017 would have visitability features. The assumed impact on the community is a 10% reduction in social isolation of wheelchair users. Population estimates of wheelchair users are derived from novel and unique analysis provided by Cornell University’s School of Industrial and Labor Relations (ILR) for this investigation. Aggregations of the drivers of health care cost were derived predominately on data from The Milken Institute. The statistics of new housing built between 2004 and 2017 in Louisville, Kentucky was provided by Louisville Metro Government Archives specifically for this study. Results: The cost of accommodating in first floor design in newly constructed housing alignment to visitability models is estimates to range from $0 to $1000 with overall average of $500. The cost of modifying newly constructed housing was significantly less than the projected healthcare cost of wheelchair users obtained from the three data sources during the study period. Conclusion: The cost of healthcare is an important political, social, and economic debate in the US. Allocation of resources in the US for healthcare has increased from 5% of GDP in 1960 to 18.3% in 2016. Public policy has sought to initiate various forms of cost controls and consumer protections, but most of these efforts have failed to make a strong impact on the