Health screening for people with intellectual disability: the New Zealand experience

Abstract

People with intellectual disability have considerable health needs and variable health care. The introduction of annual health screens for IHC residents in New Zealand resulted in some 73% of screened people requiring follow-up interventions. The introduction of the health screens raised a number of issues for management, staff, health professionals and clients who might subsequently be involved in an exercise of this type and magnitude. The importance of applying principles of management promoted by proponents of total quality management has been apparent throughout the whole exercise.

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

“…This supports the finding of the previous review that studies consistently provide evidence of health checks leading to targeted actions to address identified health needs (Baxter et al, 2006;Bollard, 1999;Hunt et al, 2001Hunt et al, , 2006Lennox et al, 2006Lennox et al, , 2007Lennox et al, , 2008Lennox et al, , 2010Lennox et al, , 2011Martin, Axon, et al, 2004;Martin, Philip, et al, 2004;McConkey et al, 2002;Webb & Rogers, 1999). 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).…”

“…Other common actions included: immunisations (Hunt et al, 2001;Lennox et al, 2006Lennox et al, , 2007Lennox et al, , 2008Lennox et al, , 2010; screening for breast, testicular or cervical cancer (Hunt et Martin, Philip, et al, 2004;McConkey et al, 2002); and general health promotion such as healthy eating advice (Hunt et al, 2006). In addition to these what might be considered routine actions, a number of life saving actions have been noted including: provision of a pacemaker, surgery for previously undetected melanoma, and mastectomy for previously undetected breast cancer (Webb & Rogers, 1999); and surgery and radiotherapy for seminoma (Wilson & Haire, 1990).…”

“…The sample sizes for those receiving health checks varied from a single case study (Marsh & Drummond, 2008) to 1311 people with intellectual disability supported by an agency in New Zealand (Webb & Rogers, 1999). A pooled analysis (Lennox et al, 2011) included a total of 795 participants of whom 407 received health checks and 388 received usual care.…”

Caring for adults with intellectual disabilities: perceived challenges for nurses in accident and emergency units

“…The research indicates that people with learning disabilities have greater healthcare needs than the general population with many of these needs remaining unmet (Van Schrojenstein Lantman-de Valk et al 1997, Center et al 1998, Scott et al 1998, Barr et al 1999, Bohmer et al 1999, Webb & Rodgers 1999, Hunt et al 2001, Cassidy et al 2002. In addition, the efforts to address these healthcare deficits continue to pose significant challenges to healthcare services, with many professionals within mainstream health services having a little or no education about intellectual disability (NHS Executive 1999, Horwitz et al 2000, DoH 2001, NHS Scotland 2002, DHSSPS 2004.…”

Primary healthcare interventions for people with intellectual disability

“…Current literature suggests that 'health assessments' or 'health checks' may increase the number of health actions, case-finding activity, and disease identification and management in people with ID (Robertson et al, 2014). Health assessments have been seen to increase diagnoses, including diagnosis of thyroid disorders, diabetes, hypertension, and then result in positive healthcare activity, for example, the provision of a pacemaker and surgery for previously undetected melanoma (Robertson et al, 2014;Webb & Rogers, 1999). Preliminary literature does indicate that health assessments may increase the number of health actions, in which case they may reduce unmet health needs and improve healthcare, contributing positively to longer-term health outcomes.…”