Accommodation as Institutional Infrastructure: A Scoping Review of Inpatient Disability Policy and Implementation
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Abstract
Adults with disabilities frequently encounter barriers in inpatient care, including environmental, communication, cognitive, and sensory challenges, despite legal obligations to provide reasonable accommodations. This study maps how inpatient accommodation policies are specified and operationalized. A PRISMA-ScR–guided scoping review was conducted across MEDLINE, Embase, CINAHL, PsycINFO, and Scopus (inception–July 2025), supplemented with grey literature. Twenty-three sources met the inclusion criteria. Policies were most developed for communication access, while accommodations addressing cognitive, psychosocial, sensory, and multi-component needs were less consistently operationalized. Implementation depended on reliable systems for identifying and documenting needs, clear role allocation, access to resources (e.g., interpreters, accessible formats, support persons), and limited mechanisms for measurement and accountability. These findings position accommodation as anticipatory, system-level infrastructure for inpatient safety and equity, while highlighting design gaps that hinder consistent delivery.
Penyandang disabilitas dewasa sering menghadapi berbagai hambatan dalam layanan rawat inap, termasuk hambatan lingkungan, komunikasi, kognitif, dan sensorik, meskipun terdapat kewajiban hukum untuk menyediakan akomodasi yang layak. Studi ini bertujuan memetakan bagaimana kebijakan akomodasi rawat inap dirumuskan dan dioperasionalisasikan. Scoping review berbasis PRISMA-ScR dilakukan melalui basis data MEDLINE, Embase, CINAHL, PsycINFO, dan Scopus (awal hingga Juli 2025), serta dilengkapi dengan literatur abu-abu. Sebanyak 23 sumber memenuhi kriteria inklusi. Kebijakan paling berkembang pada aspek akses komunikasi, sementara akomodasi untuk kebutuhan kognitif, psikososial, sensorik, dan multi-komponen masih kurang konsisten dioperasionalisasikan. Implementasi bergantung pada sistem identifikasi dan dokumentasi yang andal, kejelasan peran, akses terhadap sumber daya (misalnya interpreter dan format aksesibel), serta keterbatasan mekanisme pengukuran dan akuntabilitas. Temuan ini menempatkan akomodasi sebagai infrastruktur sistemik yang bersifat antisipatif bagi keselamatan dan keadilan layanan, sekaligus mengungkap kesenjangan desain kebijakan yang menghambat implementasi yang konsisten.
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