Health decision-making of people with disabilities: a survey-based observational study

People with disabilities are often denied the right to make decisions about their own health due to structural, social, and institutional barriers. In Chile, evidence on health decision-making among people with disabilities remains limited. This study examines the involvement in personal health decisions among adults with disabilities, drawing on the social model of disability, as defined by the Convention on the Rights of Persons with Disabilities. We analysed national data from the 2024 DISCA Survey, which included 1,074 adults with disabilities across Chile. Ordinal logistic regressions assessed how sociodemographic, economic, and health characteristics were associated with participation in personal health-care decisions. Approximately 70% of respondents indicated they could make health decisions ‘many times or always’. Women, individuals with higher income, tertiary education, or good self-rated health were more likely to participate in health decisions. Conversely, people with multiple disabilities, poor health, no income, or only special-education schooling were substantially less likely to report decision-making autonomy. These findings reveal persistent inequities in health autonomy and highlight the need for accessible information, inclusive communication, and legal mechanisms for shared decision-making in health care. Further research should explore institutional barriers to autonomy and identify strategies to strengthen disability rights in public health systems.