Key Points
Question
What individual and residential characteristics are associated with COVID-19 outcomes for people with intellectual and developmental disabilities receiving residential services?
Findings
In this cohort study of 543 adults with intellectual and developmental disabilities receiving residential services in New York City, age, larger residential settings, Down syndrome, and chronic kidney disease were associated with COVID-19 diagnosis. Heart disease was associated with COVID-19 mortality.
Meaning
This study’s findings suggest that risk factors for COVID-19 diagnosis and mortality for people with intellectual and developmental disabilities receiving residential services are similar to (age, preexisting conditions, size of residence) and unique from (Down syndrome) those reported in the general population.
The shift in living situations for adults with intellectual and other developmental disabilities (ID/DD) from family homes to group homes has raised questions about their healthcare needs and access to appropriate healthcare services. This study was undertaken to describe the disability characteristics and medical conditions in a sample of adults living in group homes in order to better understand the relationship of these variables with patterns of healthcare utilization. We examined the demographic and disability characteristics, medical conditions, and healthcare utilization of a group of individuals with ID/DD, living in 2-to 14-bed group homes operated by a large provider, who were accessing their healthcare services from a single medical practice. The data showed that this sample represented a diverse and complex group in terms of functioning, behavioral and medical conditions, presentation of high rates of challenging behaviors, rate of obesity/overweight, and utilization of health care and psychiatric services. The authors concluded that there needs to be a reexamination of the healthcare needs of individuals living in community settings, particularly with regard to the integration of healthcare and psychiatric services.
The patient-centered medical home is an innovative approach to improve health care outcomes. To address the unique needs of patients with intellectual and developmental disabilities (IDDs), a large health care provider reevaluated the National Committee for Quality Assurance's 6 medical home standards: (a) enhance access and continuity, (b) identify and manage patient populations, (c) plan and manage care, (d) provide self-care and community support, (e) track and coordinate care, and (f) measure and improve performance. This article describes issues to consider when serving patients with IDDs.
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