Health promotion for people with disabilities in Iran: Understanding the influence of home adaptation on the utilization of medical services
Shahram Akbari, Badriyeh Karami, Kianoush Abdi, Afshar Heidari, Nadia Mohammadi, Fardin Moradi, Shahin SoltaniBACKGROUND:
Difficulty moving within or exiting one’s home can limit performance and self-care and increase healthcare use in people with disabilities (PWDs). We examined whether the degree of home-adaptation difficulty predicts outpatient and inpatient service use among Iranian PWDs.
MATERIALS AND METHODS:
Secondary cross-sectional data from 766 adults registered with the Iranian Society of Disabilities were analyzed. Home adaptation, socioeconomic status (principal-component index), and disability severity (Washington Group Short Set) were collected through a validated questionnaire. Logistic regression (unadjusted, socioeconomic status (SES)-adjusted, fully adjusted) estimated odds ratios (ORs) for ≥1 medical visit in the previous month and ≥1 hospitalization in the previous year across three home-adaptation categories (no/a little, some, a lot of difficulty).
RESULTS:
Compared with those reporting no/a little difficulty, participants with “a lot” of difficulty had higher odds of medical visits in the unadjusted model (OR, 2.06; 95% CI, 1.28–3.31) and after adjustment for SES, insurance, and disability severity (OR, 8.73; 95% CI, 2.01–37.91). The partially adjusted association with hospitalization remained significant, but lost significance in the fully adjusted model.
CONCLUSION:
Severe difficulty navigating the home remains an independent driver of outpatient care in PWDs, even after accounting for disability severity and socioeconomic factors. Targeted home-modification programs, consistent with the UN Convention on the Rights of Persons with Disabilities and Iran’s national disability plan, could reduce avoidable healthcare use and promote equitable access.