Somatic healthcare utilisation patterns among older people with intellectual disability: an 11-year register study

Sandberg, Magnus; Ahlström, Gerd; Axmon, Anna; Kristensson, Jimmie

doi:10.1186/s12913-016-1880-x

Cited by 25 publications

(26 citation statements)

References 53 publications

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“…While people with ID generally are higher health care users, 30,31 our analyses do not show this for the utilization of cancer care. Reasons for the lower utilization of cancer care in this population could be twofold: (a) the incidence of some cancer types is truly lower in the ID population than in the general population, and (b) some cancer types are underdiagnosed in individuals with ID or are undertreated after diagnosis.…”

Section: Discussioncontrasting

confidence: 69%

Disparities in cancer‐related healthcare among people with intellectual disabilities: A population‐based cohort study with health insurance claims data

Cuypers¹,

Tobi²,

Huijsmans³

et al. 2020

Cancer Medicine

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Background Concerns have been raised about the accessibility and quality of cancer‐related care for people with intellectual disabilities (ID). However, there is limited insight into cancer incidence and the utilization of cancer care at the ID population level to inform targeted cancer control strategies. Therefore, we aimed to examine differences in the utilization of cancer‐related care between people with and without ID, identified through diagnostic codes on health insurance claims. Methods In a population‐based cohort study, Dutch individuals of all ages who received residential care through the Chronic Care Act due to an ID (n = 65 183) and an age and sex‐matched sample of persons without ID (1:2 ratio), who were cancer‐free at enrollment in 2013 were followed through 2015. Incidence rates (IRs) of newly started cancer care and IR ratios (IRRs) with 95% CIs were used to compare groups. Separate analyses were performed per cancer type. Results Individuals with ID received less cancer‐related care than individuals without (IRR = 0.64, 95% CI 0.62‐0.66). Differences increased with age and were larger for females than for males. Utilization of care for cancers within the national screening program (female breast, cervical, and colon cancer) was lower for people with ID compared to people without ID. Conclusion Cancer may be underdiagnosed and/or undertreated in people with ID, or cancer is truly less prevalent in this population. In particular, the differences detected between males and females with ID, and the potential underutilization of national screening programs, require urgent follow‐up investigations.

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Section: Discussioncontrasting

confidence: 69%

Disparities in cancer‐related healthcare among people with intellectual disabilities: A population‐based cohort study with health insurance claims data

Cuypers¹,

Tobi²,

Huijsmans³

et al. 2020

Cancer Medicine

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“…However, we know that older people with ID have a different health care utilisation pattern in general than people without ID, with higher proportions of unplanned care and lower proportions of planned care, especially in high ages (Sandberg et al . ). Whether such differences exist for fall‐induced health care can only be speculated on.…”

Section: Discussionmentioning

confidence: 97%

“…We have not been able to find any previously published data regarding differences between people with and without ID in inclination to seek specialist care after a fall. However, we know that older people with ID have a different health care utilisation pattern in general than people without ID, with higher proportions of unplanned care and lower proportions of planned care, especially in high ages (Sandberg et al 2016). Whether such differences exist for fallinduced health care can only be speculated on.…”

Section: Discussionmentioning

confidence: 99%

Falls resulting in health care among older people with intellectual disability in comparison with the general population

Axmon

Ahlström

Sandberg

2018

J intellect Disabil Res

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Background Falls are common among older people with intellectual disability (ID) and are also a major contributor to injuries in this population. Yet, fall characteristics have only been sparsely studied, and the results are inconsistent. The aim of the present study was to investigate type of falls, places where they occurred and activities that caused them, as well as health outcomes and health utilisation patterns after falls, among older people with ID in comparison with their age peers in the general population. Methods We established an administrative cohort of people with ID aged 55 years, or more, and alive at the end of 2012 (ID cohort; n = 7936). A cohort from the general population, one‐to‐one matched by sex and year of birth, was used as referents. Data regarding fall‐induced health care episodes in inpatient and outpatient specialist care were collected from the National Patient Register for the period 2002–2012. Results With the exception of falls from one level to another (i.e. fall on and from stairs and steps, ladder and scaffolding; fall from, out of or through building or structure; fall from tree or cliff and diving or jumping into water; or other fall from one level to another), people in the ID cohort were more likely to fall and fall more often than those in the general population cohort. Falls during a vital activity (e.g. attending to personal hygiene or eating) were twice as common among people with ID compared with the general population. When falling, people with ID were more likely to injure their head and legs but less likely to sustain injuries to the thorax and elbow/forearm. They were more likely to have superficial injuries, open wounds and fractures but less likely to have dislocations, sprain and strains. Fall‐related health care visits among people with ID were more likely to be in inpatient care and be unplanned. People with ID were also more likely than those in the general population to have a readmission within 30 days. Conclusions People with ID are more likely to require specialist care after a fall and also more likely to obtain injuries to the head, compared with the general population. This is important to consider when taking preventive measures to reduce falls and fall‐related injuries.

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“…This study is part of a project that has been described in detail elsewhere (Axmon, Björne, Nylander, & Ahlström, 2016;Sandberg, Ahlström, Axmon, & Kristensson, 2016). Briefly, the Swedish LSS register was used to identify all people with at least one measure of support for people with ID in 2012, aged at least 55 years and alive at the end of that year (ID cohort, n = 7936).…”

Section: Methodsmentioning

confidence: 99%

Incidents resulting in health care among older people with intellectual disability in comparison with the general population: A national register study

Axmon

Ekwall

Ahlström

2019

Journal of Intellectual & Developmental Disability

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Background: Older people with intellectual disability (ID) are at high risk of incidents leading to hospital visits. Method: Through national registers, 7936 people with ID, aged 55+ years in 2012, and a same-aged referent cohort from the general population were identified. Information on diagnoses made in inpatient and outpatient specialist health care during 2002-2012 was collected. Results: Compared to their age-peers in the general population, people with ID were 41% more likely to seek care for effects of foreign body entering through natural orifice, and 92% more for poisoning by drugs, medicaments and biological substances. Conclusions: There is a need to develop and evaluate evidence-based interventions to prevent unnecessary suffering and early death related to poisoning or respiratory diseases among older people with ID. To do this, implementation of risk assessments and increased knowledge of the consequences of poisoning and incidents of foreign bodies entering the respiratory organs are necessary.

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Somatic healthcare utilisation patterns among older people with intellectual disability: an 11-year register study

Cited by 25 publications

References 53 publications

Disparities in cancer‐related healthcare among people with intellectual disabilities: A population‐based cohort study with health insurance claims data

Disparities in cancer‐related healthcare among people with intellectual disabilities: A population‐based cohort study with health insurance claims data

Falls resulting in health care among older people with intellectual disability in comparison with the general population

Incidents resulting in health care among older people with intellectual disability in comparison with the general population: A national register study

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