Hospitalisation rates for ambulatory care sensitive conditions for persons with and without an intellectual disability‐a population perspective

Abstract

The large discrepancy in rates of hospitalisation between persons with and without an ID is an indicator of inadequate primary care for this vulnerable population. Decreasing the number of ambulatory care sensitive condition hospitalisations through specialised outpatient programmes for persons with an ID would potentially lead to better health, improved quality of life and cost savings. Future research should include potentially important factors such as disease severity, socio-economic variables and measures of health service organisation in the analysis. International comparisons of ambulatory care sensitive condition hospitalisation rates could point to the benefits and limitations of the health service policy directions adopted by different countries.

Preventable Emergency Hospital Admissions Among Adults With Intellectual Disability in England

“…8 There have been 3 other large-scale studies on hospitalizations of intellectually disabled adults, but they were unable to differentiate between emergency and planned admissions. 9,20,21 Our focus on preventable emergency admissions means that any comparison is difficult, as we would not expect good primary care management to decrease planned admissions for ACSCs.…”

“…[5][6][7] Studies of admissions for ACSCs in people with intellectual disabilities have shown that this population consistently has higher rates; however, one relied solely on recording of disability during hospitalization, which is incomplete, 8 and others did not distinguish between acute and planned admissions, thereby including planned admissions that are not preventable in primary care. 9 We used linkage of primary care records with hospital admission data in England to compare a large unselected group of adults with intellectual disabilities during [2009][2010][2011][2012][2013] with the general population. We report rates of both all emergency (acute) admissions and those only for ACSCs.…”

A Review of Health Surveillance in Older Adults with Intellectual and Developmental Disabilities

“…A population-based study of ambulatory care sensitive conditions (such as asthma and congestive heart failure) reported that individuals with intellectual and developmental disabilities of all ages were consistently hospitalized at a higher rate compared to individuals without intellectual and developmental disabilities (Balogh, Brownell, Ouellette-Kuntz, & Colantonio, 2010). In their representative sample of 212 older adults with intellectual and developmental disabilities (i.e., aged 60 years or more), Strydom et al (2010) reported that 51% had used hospital-based services in the last 6 months.…”

Primary healthcare interventions for people with intellectual disability

“…Recent research has demonstrated that people with ID have higher rates of emergency department visits, hospitalisations, and hospital re-admissions than the general population (Balogh, Brownell, & Ouellette-Kuntz, 2010). Some reports suggest people with ID are hospitalised at twice the rate of the general population (Beange, 1996).…”

“…With the evaluation and improvement of both the Australian health and disability system, changes will be made to optimize outcomes balanced with addressing expenditure. Australians with ID are overrepresented in emergency departments and they often have unmet heath needs that could easily be identified, treated or managed by high-quality primary care (Balogh et al, 2010;Victorian Government., 2012). This impacts on the person's quality of life and is a financial burden on the Australian health system (Victorian Government., 2012).…”