Emergency Department Visits and Use of Outpatient Physician Services by Adults with Developmental Disability and Psychiatric Disorder

Abstract

Objective:To compare the emergency department (ED), primary, and psychiatric care visit rates associated with the presence and absence of a developmental disability (DD) and a mental illness.Method: This is a population-based study comparing Ontario adults, with and without DDs and mental illnesses, in terms of rates of primary, psychiatric, and ED care, from April 2007 to March 2009. Results:In Ontario, 45% of adults with a DD received a psychiatric diagnosis during a 2-year period, and 26% of those with a psychiatric diagnosis were classified as having a serious mental illness (SMI), compared with 8% of those with a psychiatric diagnosis but no DD. People with DDs had an increased likelihood of psychiatric and ED visits. Patients with SMIs and DDs had the highest rates of such visits. Conclusions:People with more severe impairments had the greatest likelihood of ED visits, despite access to outpatient services, suggesting that outpatient care (primary and psychiatric), as currently delivered, may not be adequate to meet their complex needs. Conclusions : Les personnes souffrant de déficiences plus graves avaient la plus grande probabilité de visites au SU, malgré l'accès à des services ambulatoires, ce qui suggère que les soins ambulatoires (de première ligne et psychiatriques), tels qu'ils sont dispensés actuellement, ne sont peut-être pas adéquats pour répondre à leurs besoins complexes.

Using administrative health data to identify individuals with intellectual and developmental disabilities: a comparison of algorithms

“…) and congestive heart failure (Schultz ). The psychiatric co‐morbidity algorithm was developed as part of an Ontario study on mental health disorders and IDD () and included all mental and substance‐related conditions except for mental retardation diagnoses, psychological development disorders, behavioural/emotional disorders that onset in childhood or adolescence, and sleep disorders (the full list of psychiatric codes used is available from the authors).…”

Frequent Emergency Department Utilization and Behavioral Health Diagnoses

“…Contrary to the common misperception that frequent treat-andrelease ED users are inappropriately replacing primary care options with ED visits, evidence suggests that frequent ED users use all services (including primary care) more frequently to meet their complex health needs (Doran et al, 2013;Doupe et al, 2012;Lunsky et al, 2012;Mian & Pong, 2012). Existing studies that compare frequent ED users to those who never or rarely use the ED show that the frequent ED users are more likely to have complex chronic conditions (Billings & Raven, 2013;Capp et al, 2013;Doran et al, 2013;Lunsky et al, 2012;Meyer, Qiu, Chen, Larkin, & Altice, 2013).…”

Healthcare for Persons with Intellectual and Developmental Disability in the Community

“…Larson et al (8) reviewed access and quality issues, concluding that there are “gaps between what individuals with IDD living in community settings need and what they are able to get in health and dental care” (p. 180). The use of emergency departments persist even as people with IDD and healthcare providers acknowledge that emergency departments are inappropriate and more expensive alternatives (9–11) to accessible, quality primary medical care. Predictably, health status among people with IDD continues to lag behind that of the general population.…”