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Contributors to poor safety and quality in health care

The combination of complex healthcare needs, communication difficulties and reliance on others for support has significant implications for the delivery of health care to people with intellectual disability.2,10,[22],[23],[24]

The WHO describes the health inequity experienced by people with disability using three indicators: mortality, morbidity and functioning.10 It states that the ‘persistent and pervasive differences’ across these indicators in health outcomes for people with disability when compared with the general population are not solely explained by a ‘person’s disability or associated health conditions’. People with intellectual disability have poorer health outcomes when compared to people with other disabilities or the general population.2,[25],[26]

National and international academic literature and government reports, including the DRC final report, describe the underlying contributors to poor safety and quality in health care as:2,10,13,24,25,[27],[28],[29],[30]

  • Limited training in the healthcare needs of people with intellectual disability
  • Poor awareness of the barriers to accessing health care
  • Direct and indirect discrimination through the failure to provide reasonable adjustments 
  • Limited data collection at individual, program and systemic levels.

A reasonable adjustment is an action a service provider takes to ensure that the person can fully participate in a service or activity and receive the full benefit of that service or activity. 

The Disability Discrimination Act 1992 (Cth) (DDA) defines reasonable adjustment as ‘actions taken to eliminate or reduce direct or indirect discrimination’. The DDA requires services to make reasonable adjustments so as not to discriminate against a person on the grounds of disability.

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