An observational study of the use of acute hospital care by people with intellectual disabilities in England

Glover, Gyles; Williams, Rachael; Tompkins, Gerald; Oyinlola, Jessie

doi:10.1111/jir.12544

Cited by 25 publications

(31 citation statements)

References 16 publications

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“…Our earlier paper, describing the overall pattern of hospital admissions, set out the key strengths and weaknesses of the overall study (Glover et al . ). CPRD is a well‐established data source.…”

Section: Discussionmentioning

confidence: 97%

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An observational cohort study of numbers and causes of preventable general hospital admissions in people with and without intellectual disabilities in England

Glover

Williams

Oyinlola

2020

J intellect Disabil Res

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Background Hospital admissions for preventable reasons [ambulatory care sensitive (ACS) conditions] can indicate gaps in access to or quality of primary care. This paper seeks to document the numbers and causes of these admissions in England for people with intellectual disabilities (ID) compared with those without.Methods Observational cohort study of number and duration of emergency admitted patient episodes for ACS conditions, overall and by cause, using the Clinical Practice Research Datalink GOLD primary care database and the linked Hospital Episode Statistics Admitted Patient Care dataset. Results The study covered 5.2% of the population of England from April 2010 to March 2014 giving a total population base of 59 280 person-years for people with ID and 11 103 910 for people without identified ID. The rate of emergency admissions for ACS conditions for people with ID was 77.5 per 1000 person-years. As a crude comparison, this was 3.0 times the rate for those without ID, but standardising for the distinct demography of this group, the number of episodes was 4.8 times that expected if they had the same age-specific and sex-specific rates. Stay durations for these episodes were longer for both young-age and working-age people with ID. Overall people with ID used 399.8 beddays per 1000 person-years. As a crude comparison, this is 2.8 times the figure for people without ID. Standardising for their age and sex profile, it is 5.4 times the number expected if they had the same age-specific and sex-specific rates. For patients with ID, 16.6% (one in six) of all admitted patient episodes and 24.3% (one in four) of in-patient care days for people with ID were for ACS conditions. Corresponding figures for those without ID were 8.3% (one in 12) and 14.4% (one in seven). The difference in rates between those with and without ID was most marked in people of working age. The three most common causes of emergency episodes for ACS conditions in people with ID were convulsions and epilepsy, influenza pneumonia and aspiration pneumonitis. Influenza pneumonia was also a common cause for people without ID. Episodes for convulsions and epilepsy and aspiration pneumonitis were specifically associated with people with ID. Conclusions Rates of hospital admissions for ACS conditions provide an important indicator of health literacy, basic self-care (or support by carers) and the accessibility of primary care. High rates are seen for some conditions specifically associated with premature death in people with ID. Local monitoring of

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Section: Discussionmentioning

confidence: 97%

“…This was an observational cohort study, performed as part of a wider study of hospital admission patterns for people with ID, reported elsewhere (Glover et al . ). All English NHS general practitioners (GPs) are required to keep case notes in approved computerised notes systems.…”

Section: Methodsmentioning

confidence: 97%

An observational cohort study of numbers and causes of preventable general hospital admissions in people with and without intellectual disabilities in England

Glover

Williams

Oyinlola

2020

J intellect Disabil Res

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“…Gender and age characteristics (70% male and on average aged 43 years) reflected those with the highest presentations to ED found by Glover et al . (2019) (i.e. 57% male participants and mostly for 35–54 years), despite differences in how data were obtained (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…A concern with the current study was lack of planned admission data, but this may reflect that most adults with ID come to hospital via ED, found in the United Kingdom (Glover et al . 2019).…”

Section: Discussionmentioning

confidence: 99%

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A prospective study of hospital episodes of adults with intellectual disability

Iacono

Bigby

Douglas

et al. 2020

J intellect Disabil Res

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Background Previous research has shown poor hospital experiences and dire outcomes for people with intellectual disability. The main objective of this study was to prospectively track episodes for adults with intellectual disability (ID) in Australian hospitals, with a focus on indications of the quality of care provided. Methods A prospective audit of hospital records over 35 months yielded quantitative data about patient characteristics, frequency and length of hospital episodes, diagnostic assessments and outcomes, postemergency department (ED) destinations and postdischarge recommendations. Fifty participants were recruited largely by identification on hospital ED entry. An audit of patients' hospital records was conducted towards the end of hospital episodes, using a tool developed for the study. Results Participants were mostly men (70%), aged 42.9 years on average, living mostly with family (46%) or in supported accommodation (44%). Of 157 recorded episodes, 96% started in ED, 85% required urgent or semi-urgent care and 62% were in the first 3 months of study participation. Average time in ED exceeded the 4-h national benchmark, met in 40% of episodes. One or more diagnostic assessments were

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IDcare – a longitudinal register study of pre-pandemic and pandemic health care utilization and diagnostic profiles among people with intellectual disabilities in southern Sweden

Sandberg,

Kristensson,

Axmon

2024

Eur J Epidemiol

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The aim of the creation of this cohort was to investigate patterns of health and health care utilisation before and during the COVID-19 pandemic, overall and in relation to specific diagnoses, among people with intellectual disabilities (ID) compared to the general population. People living in Skåne, the southernmost region of Sweden, on 1st of January 2014 with at least one diagnosis of ID (ICD-10 codes F70-F79) or Down syndrome (DS; Q90), or support and/or services according to the LSS act comprised the ID cohort (n = 14 716). People living in the same family and/or household as a person in the ID cohort constituted the ID family cohort (n = 31 688), and those remaining comprised the general population cohort (gPop; n = 1 226 955). Data has been collected for all three cohorts from several national and regional registers. These include registers for health care (2014–2021), deaths (2014–2021), COVID-19-related health care (vaccinations, intensive care, palliative care, 2020–2021). The prevalence of ID was 1.2%. In the ID cohort, 77.9% had at least one measure of support, 5.8% at least one Q90-diagnosis and 63.8% had at least one F7-diagnosis (26.9% mild (F70), 7.4% moderate (F71), 2.8% severe (F72), 1.4% profound (F73), and 25.4% other/unknown (F78/F79)). Compared to the gPop there were more people in the younger age groups in the ID cohort. At this point, no additional collection of data will be carried out. However, there is a possibility to add data from the registers to include years after 2021 or from additional registers. Future publications will explore relevant research questions and report key findings in relation to health among people with ID. Future results will be used to inform policy and practice on people with ID.

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An observational study of the use of acute hospital care by people with intellectual disabilities in England

Cited by 25 publications

References 16 publications

An observational cohort study of numbers and causes of preventable general hospital admissions in people with and without intellectual disabilities in England

An observational cohort study of numbers and causes of preventable general hospital admissions in people with and without intellectual disabilities in England

A prospective study of hospital episodes of adults with intellectual disability

IDcare – a longitudinal register study of pre-pandemic and pandemic health care utilization and diagnostic profiles among people with intellectual disabilities in southern Sweden

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