How to measure multidimensional quality of life of persons with disabilities in public policies - a case of Poland

Background

The aim of this paper is to construct a tool that can be used to measure multidimensional quality of life of persons with disabilities in comparison with population without disabilities for the purpose of monitoring of the UN Convention on the Rights of Persons with Disabilities (UNCRPD) in Poland.

Methods

The Sen’s capability approach was applied to conceptualize the quality of life in various life domains. We followed guidelines of The Quality of Life Framework developed within the European Statistical System on choosing the life domains in which the QoL should be measured. The QoL scores in each domain (covered by the UNCRPD) were constructed using multiply indicators and multiple causes model (MIMIC). All analysis were based on 2018 EU-SILC data for Poland. We constructed quality of life indicators for population with and without disabilities and compared the differences.

Results

Persons without disability experienced higher QoL as compared to population with disabilities, overall and in various domains. Lower average QoL of persons with disabilities is a result of a lower share of those who experience high QoL. The biggest difference is observed for health and for productive and main activity domains. For material conditions and economic security and physical safety there was a moderate difference recorded. For the leisure and social relations domain there is almost no difference observed. Additionally, we identified diversified associations between such factors as age, gender, household situation, education, partner status, urbanization, health on the QoL across domains and analysed populations.

Conclusions

A tool developed in this paper can be calibrated to enable cross-country and in time comparisons between different populations and support evidenced-based social policy.

How do academic and career services affect employment, education, and disability benefit receipt in the transition to adulthood for youth with disabilities who have aged out of foster care?

The transition to adulthood is an important process with implications for inequality. Both those with disabilities and those who age of out of foster care are vulnerable during this transition. This project examines the intersection of these groups, exploring employment, education, and disability benefit receipt, the supports these youth receive, and how these supports may mitigate risk in this transition. Findings suggest that those with emotional or mental disabilities face employment risks in the transition to adulthood, and that services may mitigate some of this risk and present unique benefits for youth with disabilities. For example, the odds of employment are greater and the odds of receiving disability benefits are lower among those who receive academic supports (orFTE=1.3, orSSI/SSDI==0.7), post-secondary supports (orFTE=1.3, orSSI/SSDI=0.8), education financial assistance (orPTE=1.3, orSSI/SSDI=0.7), and career services (orPTE=1.3, orSSI/SSDI=0.8). These services should be prioritized for funding, especially education financial assistance as a lower proportion of youth with disabilities receive than their non-disabled peers.

Differential Risks: How Disability Shapes Risk in the Transition to Adulthood for Youth who Age Out of Foster Care

OBJECTIVE

This study examines how disability is associated with risk during the transition to adulthood for youth who age out of foster care and considers how experiences in the child welfare system contribute to these associations.

BACKGROUND

The transition to adulthood is important for later socioeconomic standing, health, and wellbeing. Youth who age out of foster care with disabilities may require a high level of support during this transition yet may lack support.

METHOD

This study employs linear probability models to estimate the association between disability and incarceration, homelessness, childbearing, and substance abuse between ages 17 and 21 using linked administrative data from the National Data Archive on Child Abuse and Neglect (N=5,221).

RESULTS

Having a physical or sensory disability is associated with lower risk in the transition to adulthood. Alternatively, having an emotional or mental related disability is associated with increased risk of incarceration and homelessness, but the association with homelessness is accounted for by child welfare experiences.

CONCLUSION

Due to the importance of foster care and child protective histories in explaining some risky outcomes for youth with emotional and mental disabilities, policy makers and practitioners should include those early stages of care when seeking it improve outcomes in the transition to adulthood for youth with disabilities who age out of foster care.

Implementation and Evaluation of a Neurology Telemedicine Initiative at a Major Academic Medical Center

Objective: The COVID-19 pandemic forced rapid adoption of telemedicine for care of neurology patients. This study contributes to this literature by describing the structure and implementation of telemedicine-based outpatient neurology clinics at the UCLA Medical Center and estimates patient cost savings, before and after the California COVID-19 "Safer at Home" directive, and patient satisfaction. Methods: This was a retrospective, nonrandomized, case series study of telemedicine-based neurological management in an urban academic medical center from October 2018 to June 2020. We estimated roundtrip travel time, roundtrip travel distance, total savings, and surveyed patient and provider satisfaction with telemedicine care. We supported these findings through evaluation of 7,194 patients by telemedicine and conducted 9,189 video visits for neurological care. Results: The median telemedicine patient avoided a roundtrip driving distance of 33 miles and roundtrip travel time of 75 min. Within sample, median hourly earnings were $27/h. The median patient saved $18 on fuel and parking and $36 of time-based opportunity savings, for total savings of $54 per video visit. Eighty-six percent of patients surveyed were satisfied with their video visit experience. Conclusions: Telemedicine reduced travel time and also reduced costs for neurology patients. Patients and providers both reported high levels of satisfaction with telemedicine.