Rate and characteristics of urgent hospitalisation in persons with profound intellectual disabilities compared with general population

Amor-Salamanca, A.; Menchón, José M.

doi:10.1111/jir.12436

Cited by 4 publications

(6 citation statements)

References 30 publications

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“…The only study identified by the authors to report no difference in ACS admission rates between people with profound ID and those without ID was that of Amor‐Salamanca and Menchon from Barcelona, Spain (Amor‐Salamanca and Menchon ). These authors however were reporting the rate of admission of individuals who attended hospital emergency departments, not people in the population.…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

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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“… Predictors of Emergency Room and Hospital Utilization Among Adults with Intellectual and Developmental Disabilities 23 Blaskowitz, M. G.; Hernandez, B.; Scott, P. W. 2019 USA Adults with intellectual and developmental disability n: 597 None Age, gender, level of intellectual disability, chronic health problems, mental health diagnoses, polypharmacy, supported living arrangement, region ER use for a medical/physical reason, hospitalization for a medical/physical reason, ER use for a behavioral/psychiatric reason, hospitalization for a behavioral/psychiatric reason Prevalence study, secondary data: survey of medical charts Predictors (environmental and individual risk factors) for ED use: institutionalized people are less likely to be admitted; people from deprived neighborhoods with a lack of care are less likely to visit the ED 2. Rate and characteristics of urgent hospitalization in persons with profound intellectual disabilities compared with general population 24 Amor-Salamanca, A.; Menchon, J. M. 2018 Spain Adults with severe/ profound intellectual disability n: 28 Other hospitalized ED patients n: 83 Gender, age, living arrangement Emergency visits, admission to hospital after emergency visit Retrospective cohort study, secondary data: discharge reports No differences in the proportion of people with profound intellectual disability and controls admitted to hospital after their emergency visit; the median hospital stay was higher for people with profound intellectual disability s: 7.5 vs 4 days for controls 3. Factors associated with ambulatory care sensitive emergency department visits for South Carolina Medicaid members with intellectual disability 25 McDermott, S.; Royer, J.…”

Section: Methodsmentioning

confidence: 99%

“… Emergency Department Use: Common Presenting Issues and Continuity of Care for Individuals with and without Intellectual and Developmental Disabilities 34 Durbin, A.; Balogh, R.; Lin, E.; Wilton, A. S.; Lunsky, Y. 24 2018 Canada Adults with intellectual and developmental disability n: 66,484 Adults without intellectual and developmental disability n: 2,760,670 Level of continuity of primary care ED visits Retrospective cohort study, secondary data: administrative health and social services data Individuals with intellectual and developmental disability were more likely than individuals with no intellectual and developmental disability to visit the ED; for both groups, greater primary care continuity was associated with less ED use, but this relationship was more marked for adults with intellectual and developmental disability 13. Use of health services in the last year of life and cause of death in people with intellectual disability: a retrospective matched cohort study 35 Brameld, K.; Spilsbury, K.; Rosenwax, L.; Leonard, H.; Semmens, J.…”

Section: Methodsmentioning

confidence: 99%

Emergency Medical Care of People with Intellectual Disabilities: A Scoping Review

York¹,

Wechuli²,

Karbach³

2022

OAEM

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Purpose The paper intends to do a scoping review of people with intellectual disabilities in emergency care where this group seems to face access barriers and discrimination. It analyses the conceptual and methodological framework for studies examining the former. Methods A scoping review is conducted. The studies’ quality is assessed via a checklist developed by the authors drawing on a compilation of common assessment tools for study quality. Results Fourteen quantitative studies fulfil the inclusion criteria for further analysis. Summary measures are extracted. Results are synthesized with Andersen’s Behavioral Model of Health Service Use. Studies employ a combination of variables attributable to different aspects of population characteristics and health behavior. Conclusion Most studies seek to quantify or predict emergency care overuse by people with intellectual disabilities. Future studies should also take patients’ poor health or treatment outcomes and their perspectives into account.

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“…Intellectually disabled (ID) patients present unique therapeutic challenges. They demand more medical resources than the general population [1] and have higher rates of hospital and intensive care unit (ICU) admission [2].…”

Section: Introductionmentioning

confidence: 99%

“…ID patients suffer lifelong disability and early mortality [4,5]. Compared to the general population, they undergo more hospitalizations [2] and when hospitalized have longer lengths of in-hospital stay [4,6]. They are admitted more frequently after surgical procedures, have more complications [7,8] and are also more likely to die during hospitalization [9,10].…”

Section: Introductionmentioning

confidence: 99%

Intellectually disabled patients’ intensive care admission characteristics, weaning from mechanical ventilation, and sedative drug use: a single-center retrospective case-control study

Bineth

Barel

Bdolah‐Abram

et al. 2022

J Anesth Analg Crit Care

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Background Intellectually disabled (ID) patients present unique therapeutic challenges. We aimed to describe the characteristics of ID patients admitted to a general intensive care unit (ICU). Results We conducted a retrospective cohort study comparing critically ill adult ID patients to matched patients without ID (1:2 ratio) in a single ICU (2010–2020). The main outcome measure was mortality. Secondary outcomes included complications during admission and characteristics of weaning from mechanical ventilation. The study and control groups were randomly selected based on similar age and sex. ID patients nonetheless had an average APACHE score of 18.5 ± 8.7 vs. 13.4 ± 8.5 in controls (p < 0.001). ID patients had more hematological (p = 0.04), endocrinological (p < 0.001) and neurological (p = 0.004) comorbidities and used more psychiatric medication before admission. No difference was found in mortality rates. Differences were found as there were more secondary complications, such as pulmonary and sepsis (p < 0.03), frequent requirement of vasopressors (p = 0.001), significantly higher intubation rates with more weaning attempts, tracheostomies and longer ICU and hospital admissions (p < 0.019). Conclusions Critically ill adult ID may have more comorbidities and be sicker at the time of admission compared to their age- and sex-matched counterparts. They require more supportive treatment and their weaning from mechanical ventilation may be more challenging.

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Rate and characteristics of urgent hospitalisation in persons with profound intellectual disabilities compared with general population

Cited by 4 publications

References 30 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

Emergency Medical Care of People with Intellectual Disabilities: A Scoping Review

Intellectually disabled patients’ intensive care admission characteristics, weaning from mechanical ventilation, and sedative drug use: a single-center retrospective case-control study

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