The Impact of Checking the Health of Adults with Intellectual Disabilities on Primary Care Consultation Rates, Health Promotion and Contact with Specialists

Abstract

Background Studies have found that health checking in primary care led to the identification of previously unrecognized morbidity among adults with intellectual disabilities. The aim here was to evaluate whether health checking stimulated increased consultation with the general practitioner or another member of the primary care team, increased health promotion actions undertaken outside the health check or increased contact with specialists. Method Data on the above three categories of activity were abstracted from the medical records of 77 adult participants with intellectual disabilities for eight 6-month periods before and seven 6 month periods after they had undergone a health check. Comparisons of access to care before and after the health check were made using non-parametric statistics. Results On average, participants had 5.4 and 1.8 primary care and specialist consultations per year respectively. There were no significant differences in either rate before and after the health check. The frequency of health promotion actions increased significantly after the health check from a mean of 1.2 to 2.2 ⁄ year. Conclusions Comparison of the primary care and specialist consultations rates of people with intellectual disabilities with those for the general population might suggest that the former have greater access to these services. However, comparison to the general practitioner consultation rates of patients with other chronic conditions would seem to indicate that contact with primary care may not be commensurate with need. Attention to health promotion is inadequate. Further research is required to substantiate whether health checking increases health promotion and how increased health promotion activity would affect the health of this population.

The impact of health checks for people with intellectual disabilities: An updated systematic review of evidence

“…In the UK, an audit of actions resulting from health checks for 190 participants, of whom 93 had new health needs identified, indicated that management had been initiated for 90% of identified needs by the time of the audit and treatment concluded for 61% of needs (Baxter et al, 2006). However, whilst a study in Wales found a significant increase in health promotion actions post health check, there was no significant change in rates of contact with primary or specialist care (Felce et al, 2008b).…”

“…Overall, the majority of the publications identified were based on studies conducted in the UK, including 19 from England (Backer & Jervis, 2007;Bollard, 1999;Cassidy et al, 2002;Chapman, 2012;Chauhan, Kontopantelis, Campbell, Jarrett, & Lester, 2010;Chauhan et al, 2012;Codling, 2007Codling, , 2012Hunt, Wakefield, & Hunt, 2001;Hunt, Rankine, & Blackmore, 2006;Martin, Axon, & Baillie, 2004;Martin, Philip, et al, 2004;Martin, 2003;Martin, Roy, Wells, & Lewis, 1997;Michell, 2012;Walmsley, 2011;Wells, Turner, Martin, & Roy, 1997;Wilson & Haire, 1990), 5 from Wales (Baxter et al, 2006;Felce et al, 2008aFelce et al, , 2008bJones & Kerr, 1997;Perry et al, 2010) 4 from Scotland (Cooper et al, 2006;Jones et al, 2009;McKenzie & Powell, 2004;Romeo et al, 2009), and 3 from Northern Ireland (Barr et al, 1999;McConkey, 2013;McConkey, Moore, & Marshall, 2002). Additional publications were identified based on studies conducted in the following countries: 8 from Australia (Beange et al, 1995;Gordon, Holden, Ware, Taylor, & Lennox, 2012;Lennox, Green, Diggens, & Ugoni, 2001;Lennox, Rey-Conde, & Cooling, 2006;Lennox et al, 2007Lennox et al, , 2010Lennox et al, , 2013Lennox, Rey-Conde, & Fa...…”

Health inequalities and people with learning disabilities in the UK

“…For example, comparison of general practitioner consultation rates to those of patients with other chronic conditions suggests that primary care access rates for people with learning disabilities are lower than might be expected. 140 Collaboration between GPs, primary health care teams and specialist services for people with learning disabilities is generally regarded as poor. 141 Adults aged over 60 with learning disabilities are less likely to receive a range of health services compared to younger adults with learning disabilities.…”

Intellectual disability and mental health problems: a qualitative study of general practitioners’ views

“…[1][2][3][4][5][6][7] Two recent attempts provide a focus to this challenge: a consensus manifesto by the European Association of Intellectual Disability Medicine 8 and an independent inquiry on a request from the British Secretary of State for Health. 9 These reports share the goal of improving healthcare services for people with ID, but the extent to which their recommendations have been implemented remains dubious.…”