Investigating the widely held belief that men and women with learning disabilities receive poor quality healthcare when admitted to hospital:A single-site study of 30-day readmission rates.
AbstractObjective: To use 30-day readmission rates to investigate the presumption that men and women with learning disabilities (LDs, known internationally as intellectual disabilities) receive poorer quality hospital care than their non-disabled peers.
Method:A 12-month retrospective audit was conducted using Hospital Episode Statistics (HES) at a single acute hospital in the East of England. This identified: all in-patient admissions; admissions where the person concerned was recognised as having a learning disability; and all emergency readmissions within 30-days of discharge. Additionally, the healthcare records of all patients identified as having a learning disability and readmitted within 30-days as a medical emergency were examined in order to determine whether or not these readmissions were potentially preventable.
Results:Over the study period a total of 66,870 adults were admitted as in-patients, amongst whom 7,408 were readmitted as medical emergencies within 30 days of discharge: a readmission rate of 11%. Of these 66,870 patients, 256 were identified as having a learning disability, with 32 of them experiencing at least one emergency readmission within 30-days: a readmission rate of 13%. When examined, the healthcare records pertaining to these 32 patients who had a total of 39 unique 30-day readmissions, revealed that 69% (n= 26) of these readmissions were potentially preventable.
Conclusion:Although overall readmission rates were similar for patients with learning disabilities and those from the general population, patients with learning disabilities had a
BackgroundWe report striking and unanticipated improvements in maladaptive behaviours in Prader–Willi syndrome (PWS) during a trial of vagus nerve stimulation (VNS) initially designed to investigate effects on the overeating behaviour. PWS is a genetically determined neurodevelopmental disorder associated with mild–moderate intellectual disability (ID) and social and behavioural difficulties, alongside a characteristic and severe hyperphagia.MethodsThree individuals with PWS underwent surgery to implant the VNS device. VNS was switched on 3 months post‐implantation, with an initial 0.25 mA output current incrementally increased to a maximum of 1.5 mA as tolerated by each individual. Participants were followed up monthly.ResultsVagal nerve stimulation in these individuals with PWS, within the stimulation parameters used here, was safe and acceptable. However, changes in eating behaviour were equivocal. Intriguingly, unanticipated, although consistent, beneficial effects were reported by two participants and their carers in maladaptive behaviour, temperament and social functioning. These improvements and associated effects on food‐seeking behaviour, but not weight, indicate that VNS may have potential as a novel treatment for such behaviours.ConclusionsWe propose that these changes are mediated through afferent and efferent vagal projections and their effects on specific neural networks and functioning of the autonomic nervous system and provide new insights into the mechanisms that underpin what are serious and common problems affecting people with IDs more generally.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.