Numbers and Policy in Care for People with Intellectual Disability in the United Kingdom

Glover, Gyles

doi:10.1111/jar.12131

Cited by 5 publications

(6 citation statements)

References 16 publications

(13 reference statements)

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“…22 In particular, with increasing life expectancy for this population, 23 it is essential that preventable admissions are described so that appropriate interventions can be developed. Our work is the first in the United Kingdom to use an unselected group of adults with intellectual disabilities to accurately quantify differences in emergency admissions.…”

Section: Discussionmentioning

confidence: 99%

Preventable Emergency Hospital Admissions Among Adults With Intellectual Disability in England

et al. 2017

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PURPOSE Adults with intellectual disabilities experience poorer physical health and health care quality, but there is limited information on the potential for reducing emergency hospital admissions in this population. We describe overall and preventable emergency admissions for adults with vs without intellectual disabilities in England and assess differences in primary care management before admission for 2 common ambulatory care-sensitive conditions (ACSCs). METHODSWe used electronic records to study a cohort of 16,666 adults with intellectual disabilities and 113,562 age-, sex-, and practice-matched adults without intellectual disabilities from 343 English family practices. Incident rate ratios (IRRs) from conditional Poisson regression were analyzed for all emergency and preventable emergency admissions. Primary care management of lower respiratory tract infections and urinary tract infections, as exemplar ACSCs, before admission were compared in unmatched analysis between adults with and without intellectual disabilities. RESULTSThe overall rate for emergency admissions for adults with vs without intellectual disabilities was 182 vs 68 per 1,000 per year (IRR = 2.82; 95% CI, 2.66-2.98). ACSCs accounted for 33.7% of emergency admissions among the former compared with 17.3% among the latter (IRR = 5.62; 95% CI, 5.14-6.13); adjusting for comorbidity, smoking, and deprivation did not fully explain the difference (IRR = 3.60; 95% CI, 3.25-3.99). Although adults with intellectual disability were at nearly 5 times higher risk for admission for lower respiratory tract infections and urinary tract infections, they had similar primary care use, investigation, and management before admission as the general population.CONCLUSIONS Adults with intellectual disabilities are at high risk for preventable emergency admissions. Identifying strategies for better detecting and managing ACSCs, including lower respiratory and urinary tract infections, in primary care could reduce hospitalizations. Ann Fam Med 2017;15:462-470. https://doi.org/10.1370/afm.2104. INTRODUCTIONA dults with intellectual disabilities experience poorer health outcomes than their peers in the general population and have higher levels of morbidity and mortality.1 They also receive poorer-quality health care for a range of reasons including discrimination, communication difficulties, and barriers to access.2 Despite international recommendations, 2,3 this group remains largely invisible to routine data collection and analysis. 4 Acute hospitalization is highly undesirable for individuals with intellectual disabilities, and reducing preventable admissions is particularly important.Ambulatory care-sensitive conditions (ACSCs) are those for which prevention or effective management in primary care should decrease the risk of acute hospitalization, and they are widely used as an indicator of access to and quality of primary care. [5][6][7] Studies of admissions for ACSCs in people with intellectual disabilities have shown that this population consistently...

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Section: Discussionmentioning

confidence: 99%

Preventable Emergency Hospital Admissions Among Adults With Intellectual Disability in England

et al. 2017

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“…There is a consensus among the scientific community that more evidence and ongoing surveillance are needed to document health inequities in healthcare services among people with intellectual and developmental disabilities (Ervin & Rubin, ; Lunsky, Balogh, Sullivan, & Jaakkimainen, ; Naaldenberg et al, ; Ouellette‐Kuntz et al, ). Empirical evidence is crucial to support the process of making effective health policy, from the conception of public health policies to the evaluation of their implementation (Glover, ).…”

Section: Introductionmentioning

confidence: 99%

Healthcare services utilization among people with intellectual disability and comparison with the general population

Maltais

Morin

Tassé

2020

Research Intellect Disabil

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Background Studies have reported unmet health needs in individuals with intellectual disability (ID). This study illustrated and analysed patterns of healthcare services utilization among people with intellectual disability and compared their use to that of the general population. Method Participants (N = 791, aged 15–82) were mainly recruited through government‐financed agencies specializing in services for people with intellectual disabilities in Québec, Canada. Comparisons were possible by using health administrative data. Results Some services were more used by people with intellectual disability than the general population (general medicine, psychiatry, PSA blood tests), and others were accessed at significantly lower frequencies (optometry, physiotherapy, Pap tests). Similar rates were found for mammography, dentistry and psychology. Inequities were more salient for individuals who had more severe levels of intellectual disability. Conclusions Our findings support that the population with intellectual disability would benefit from policies and practices aimed at enhancing the access to healthcare services.

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“…These are best estimates: there is no definitive record of the number of people with intellectual disabilities in England as such information is not collected nationally. However, less than a quarter (24%; n = 214 352) of adults with intellectual disabilities are registered as having intellectual disabilities by a family doctor (GP) in the National Health Service (NHS) (Health and Social Care Information Centre ) – a substantial underestimate of the true prevalence (Glover p. 14) – and only 20% ( n = 177 389) of adults with intellectual disabilities in England are users of specialized social care services for people with intellectual disabilities. There is therefore a ‘hidden majority’ of people with mainly mild and moderate intellectual disabilities who are not recorded as having intellectual disabilities by their GPs, and who are not known to, or who do not use, specialized social care services for people with intellectual disabilities.…”

Section: Introductionmentioning

confidence: 99%

Mortality of People with Intellectual Disabilities in England: A Comparison of Data from Existing Sources

Heslop

Glover

2015

Research Intellect Disabil

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Numbers and Policy in Care for People with Intellectual Disability in the United Kingdom

Abstract: Different levels of precision or coverage are required at different stages of the process. Different types of numerical data are appropriate at the various stages of the policy process.

Cited by 5 publications

References 16 publications

Preventable Emergency Hospital Admissions Among Adults With Intellectual Disability in England

Preventable Emergency Hospital Admissions Among Adults With Intellectual Disability in England

Healthcare services utilization among people with intellectual disability and comparison with the general population

Mortality of People with Intellectual Disabilities in England: A Comparison of Data from Existing Sources

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