Improving health and lives: The Learning Disabilities Public Health Observatory

Emerson, Eric; Glover, Gyles; Turner, Sue; Greig, Robert; Hatton, Chris; Baines, Susannah; Copeland, Alison; Evison, Felicity; Roberts, Hazel; Robertson, Janet; Welch, Vicki

doi:10.1108/20441281211198835

Cited by 88 publications

(82 citation statements)

References 8 publications

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“…Maes et al (2003) and Emerson et al (2010), found similar results in caregivers of child and adult with an ID-MD. The presence of behavioral problems, psychotic and affective symptoms increases the risk of having greater family burden.…”

Section: Discussionsupporting

confidence: 67%

“…Therefore, a holistic view should include the understanding of family burden in biopsychosocial framework (World Health Organization [WHO], 2001). One study of unpaid caregivers of people with learning disabilities referring to intellectual disabilities in the United Kingdom found that 75% of caregivers of an adult with ID had been caring for more than 20 years, 26% reported not being in paid employment due to their responsibilities, and 48% spent 100 or more hours a week caring for that person (Emerson et al, 2010). However, 90% of those caregivers felt they were or were usually involved as much as they wanted to be in decisions about the care and treatment of the person they cared for.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Family burden related to clinical and functional variables of people with intellectual disability with and without a mental disorder

Irazábal

Marsà

García

et al. 2012

Research in Developmental Disabilities

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Section: Discussionsupporting

confidence: 67%

mentioning

confidence: 99%

Family burden related to clinical and functional variables of people with intellectual disability with and without a mental disorder

Irazábal

Marsà

García

et al. 2012

Research in Developmental Disabilities

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“…164 Knowledge of the health risks associated with specific syndromes is of value in targeting the content of health checks;…”

Section: Secondary Health Carementioning

confidence: 99%

Health inequalities and people with learning disabilities in the UK

Emerson

Baines

2011

Tizard Learning Disability Rev

Self Cite

342

335

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“…39,50 This may be because the majority of these patients do not use specialised services for adults with ID and, as a result, are not well known to primary care. The prevalence estimate of 2.17% calculated by Public Health England in 2013 50 would mean that three out of four patients with ID are not currently on QOF learning disability registers.…”

Section: Quality and Outcomes Framework And Learning Disabilitymentioning

confidence: 99%

“…An associated reduction in emergency hospital admissions is likely to be a key measurable and valued benefit from annual health checks, as people with ID experience high levels of emergency admissions. 39 Additionally, unplanned Determine whether or not practice participation in the annual health check DES improves outcomes for people with ID See Chapter 6…”

Section: Evidence Base For Annual Health Checksmentioning

confidence: 99%

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

Carey

Hosking

Harris

et al. 2017

Health Serv Deliv Res

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Background People with intellectual disability (ID) have poorer health than the general population; however, there is a lack of comprehensive national data describing their health-care needs and utilisation. Annual health checks for adults with ID have been incentivised through primary care since 2009, but only half of those eligible for such a health check receive one. It is unclear what impact health checks have had on important health outcomes, such as emergency hospitalisation. Objectives To evaluate whether or not annual health checks for adults with ID have reduced emergency hospitalisation, and to describe health, health care and mortality for adults with ID. Design A retrospective matched cohort study using primary care data linked to national hospital admissions and mortality data sets. Setting A total of 451 English general practices contributing data to Clinical Practice Research Datalink (CPRD). Participants A total of 21,859 adults with ID compared with 152,846 age-, gender- and practice-matched controls without ID registered during 2009–13. Interventions None. Main outcome measures Emergency hospital admissions. Other outcomes – preventable admissions for ambulatory care sensitive conditions, and mortality. Data sources CPRD, Hospital Episodes Statistics and Office for National Statistics. Results Compared with the general population, adults with ID had higher levels of recorded comorbidity and were more likely to consult in primary care. However, they were less likely to have long doctor consultations, and had lower continuity of care. They had higher mortality rates [hazard ratio (HR) 3.6, 95% confidence interval (CI) 3.3 to 3.9], with 37.0% of deaths classified as being amenable to health-care intervention (HR 5.9, 95% CI 5.1 to 6.8). They were more likely to have emergency hospital admissions [incidence rate ratio (IRR) 2.82, 95% CI 2.66 to 2.98], with 33.7% deemed preventable compared with 17.3% in controls (IRR 5.62, 95% CI 5.14 to 6.13). Health checks for adults with ID had no effect on overall emergency admissions compared with controls (IRR 0.96, 95% CI 0.87 to 1.07), although there was a relative reduction in emergency admissions for ambulatory care-sensitive conditions (IRR 0.82, 95% CI 0.69 to 0.99). Practices with high health check participation also showed a relative fall in preventable emergency admissions for their patients with ID, compared with practices with minimal participation (IRR 0.73, 95% CI 0.57 to 0.95). There were large variations in the health check-related content that was recorded on electronic records. Limitations Patients with milder ID not known to health services were not identified. We could not comment on the quality of health checks. Conclusions Compared with the general population, adults with ID have more chronic diseases and greater primary and secondary care utilisation. With more than one-third of deaths potentially amenable to health-care interventions, improvements in access to, and quality of, health care are required. In primary care, better continuity of care and longer appointment times are important examples that we identified. Although annual health checks can also improve access, not every eligible adult with ID receives one, and health check content varies by practice. Health checks had no impact on overall emergency admissions, but they appeared influential in reducing preventable emergency admissions. Future work No formal cost-effectiveness analysis of annual health checks was performed, but this could be attempted in relation to our estimates of a reduction in preventable emergency admissions. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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Improving health and lives: The Learning Disabilities Public Health Observatory

Cited by 88 publications

References 8 publications

Family burden related to clinical and functional variables of people with intellectual disability with and without a mental disorder

Family burden related to clinical and functional variables of people with intellectual disability with and without a mental disorder

Health inequalities and people with learning disabilities in the UK

An evaluation of the effectiveness of annual health checks and quality of health care for adults with intellectual disability: an observational study using a primary care database

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