Time trends in emergency department use among adults with intellectual and developmental disabilities

Horner‐Johnson, Willi; Lindner, Stephan; Levy, Anna; Hall, Jean P.; Kurth, Noelle K.; García, Erika González; Frame, Alice; Phillips, Kimberly G.; Momany, Elizabeth T.; Lurie, Melissa; Shin, Yejee; Lauer, Emily; Kunte, Parag; Silverstein, Robin P.; Okoro, Catherine A.; McDermott, Suzanne

doi:10.1016/j.dhjo.2021.101225

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…Among state-level factors we found only that state Medicaid expansion was significantly associated with an increased likelihood of completing a colonoscopy screening among younger persons in the sample (e.g., in their 50s). This coheres with recent research concerning Medicaid expansion and emergency department visits among adults with IDD (Horner-Johnson et al, 2022). However, significant variation at the state level remained, indicating that unmeasured state-level factors are likely associated with healthcare screenings as well.…”

Section: Discussionsupporting

confidence: 89%

“…Adults with IDD living in states without Medicaid expansion may be at greater risk of failing to receive important preventive measures such as mammograms and colonoscopies, especially before reaching the age for Medicare eligibility. Recent evidence suggests that Medicaid expansion was associated with a reduction in emergency department visits among the population with IDD, a potential sign of better preventive care (Horner-Johnson et al, 2022). In addition to examining individual factors associated with mammogram and colonoscopy screening completion among the population aging with IDD, we aim to explore (1) state-level variation in screening completion, and (2) whether Medicaid expansion is associated with screening completion, particularly at younger ages before individuals reach the age of Medicare eligibility (65+) or Medicare/Medicaid dual-eligibility.…”

Section: Introductionmentioning

confidence: 99%

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Preventive Healthcare Screening Completion Among Midlife and Older Adults With Intellectual and Developmental Disabilities

et al. 2023

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Individuals with intellectual and developmental disabilities (IDD) face several barriers to healthcare, making them less likely to receive numerous routine preventive health screenings. Preventive healthcare is a critical aspect to maintaining health and wellness, particularly for people with complex health needs. This study examines individual- and state-level factors associated with mammogram and colonoscopy screenings in mid- and later-life foradults with IDD receiving state services. Multilevel logistic regression models analyzed data from the 2012-2013 and 2018-2019 waves of the National Core Indicators In-Person Survey (NCI-IPS). Results indicated that factors such as age, living situation, transportation access, and community involvement were associated with completion of both preventive screenings. Medicaid expansion was associated with a significantly greater likelihood of completing a colonoscopy screening only among younger persons in the sample (i.e., in their 50s). These findings may have implications for completion of preventive health screenings for adults with IDD.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Preventive Healthcare Screening Completion Among Midlife and Older Adults With Intellectual and Developmental Disabilities

et al. 2023

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“…19 Also, previous studies have reported higher utilization of healthcare services for people with IDD, compared to the general population; 20 and that high use of acute care services may be due in part to greater complexity of health needs in adults with IDD. 18 , 21 Further, a recent study of ED usage among people with IDD showed there was not substantial changes in ED visits during the period of Medicaid expansion, 22 which implies that the issue involves more than the availability of health insurance coverage.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Controlled Trial using Brief Educational Messages Directed to Adults with Intellectual Disability and Hypertension or their Helpers Reduces Hospital Stays

et al. 2023

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Purpose We assessed an educational intervention to reduce the number of emergency department (ED) and inpatient stays for cardiovascular diagnoses, among South Carolina adult Medicaid Members with intellectual and developmental disability and hypertension (Members). Design This Randomized Controlled Trial (RCT) included Members or the person who helped them with their medications (Helpers). Participants, who included Members and/or their Helpers, were randomly assigned to an Intervention or Control group. Setting South Carolina Department of Health and Human Services, which administers Medicaid, identified eligible Members. Sample 412 Medicaid Members - 214 Intervention (54 Members participating directly; 160 Helpers participating in lieu of Members) who received the messages about hypertension and surveys about knowledge and behavior and 198 Controls (62 Members; 136 Helpers) who only received surveys of knowledge and behavior. Intervention Educational intervention about hypertension included a flyer and monthly text or phone messages for one year. Measures Input measures - characteristics of the Members; Outcome measures - hospital emergency department (ED) and inpatient visits for cardiovascular conditions. Analysis Quantile regression tested the association of Intervention/Control group status with ED and inpatient visits. We also estimated models using Zero-inflated Poisson (ZIP) models for sensitivity analysis. Results Participants in the Intervention group with highest baseline hospital use (top 20% ED; top 15% Inpatient) had significant reductions in Year 1 (.57 fewer ED and 2 fewer inpatient days) compared to the Control group. For ED visits, improvement continued in year two. Conclusion The intervention reduced the frequency of cardiovascular disease-related ED visits and Inpatient days for participants in the Intervention group in the highest quantiles of hospital use, and the improvement was better for those who had a Helper.

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Time trends in emergency department use among adults with intellectual and developmental disabilities

Cited by 2 publications

References 26 publications

Preventive Healthcare Screening Completion Among Midlife and Older Adults With Intellectual and Developmental Disabilities

Preventive Healthcare Screening Completion Among Midlife and Older Adults With Intellectual and Developmental Disabilities

A Randomized Controlled Trial using Brief Educational Messages Directed to Adults with Intellectual Disability and Hypertension or their Helpers Reduces Hospital Stays

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