Development of a disability-inclusive healthcare service: review of the Healthcare Accreditation Programme in Thailand
Keywords:disability-inclusive, development, healthcare accreditation, rehabilitation standard
AbstractDespite decades of global agendas on disability inclusive development, persons with disabilities continue to experience many barriers to quality health care. The Healthcare Accreditation Programme is one instrument facilitating healthcare quality development. As the standard manual is the core component of the programme, this study explores the disability-inclusiveness of the standard against an inclusive framework developed by synthesizing key elements of the UN Convention on the Rights of Person with Disabilities (UNCRPD) and the International Classification of Functioning, Disability and Health (ICF). The general healthcare standards and rehabilitation facilities standards were searched purposively to evaluate those used in Thailand and to compare them with those in other countries where rehabilitation accreditation programmes are widely implemented, such as the USA, the UK, and Australia. The rehabilitation specific standards appear more concerned with mainstreaming disability. The general healthcare standards are less disability inclusive. Although rehabilitation services are mentioned in the standards but functional evaluations are not always indicated. Both rehabilitation and general standards appear to neglect barriers to general health care and the human rights of persons with disabilities. The accreditation programme can facilitate the disability-inclusive healthcare if its standards are revised to address concerns over client’s rights, especially by avoiding substituted decision making and embracing accessibility evaluation and removal of barriers. In addition, it needs to emphasize a participatory approach in care processes, the functional evaluation and the focus on personal independence and social re-integration.
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