Predictors of Emergency Room and Hospital Utilization Among Adults With Intellectual and Developmental Disabilities (IDD).

Emergency room (ER) and hospital utilization among people with intellectual and developmental disabilities (IDD) are significant contributors to rising healthcare costs. This study identifies predictors of utilization among 597 adults with IDD. Using a retrospective survey of medical charts, descriptive statistics and logistic regressions were conducted. Individual-level risk factors for ER utilization included age, number of chronic health conditions, a diagnosis of cerebral palsy or neurological disorder, mental illness, and polypharmacy. Environmental predictors included community-based supported living. Hospitalization predictors included age and number of chronic illnesses. People residing in group homes were less likely to be admitted. This study found risk factors unique to individuals with IDD that should be addressed with tailored interventions as states transition to Medicaid managed care.

[1]  Lisa O'Leary,et al.  Early death and causes of death of people with intellectual disabilities: A systematic review , 2018, Journal of applied research in intellectual disabilities : JARID.

[2]  K. Dunn,et al.  Hospital admissions for physical health conditions for people with intellectual disabilities: Systematic review , 2018, Journal of applied research in intellectual disabilities : JARID.

[3]  G. Weber,et al.  Job Satisfaction, Quality of Work Life and Work Motivation in Employees with Intellectual Disability: A Systematic Review , 2018, Journal of applied research in intellectual disabilities : JARID.

[4]  Gillian E. Caughey,et al.  What is polypharmacy? A systematic review of definitions , 2017, BMC Geriatrics.

[5]  D. Cook,et al.  Preventable Emergency Hospital Admissions Among Adults With Intellectual Disability in England , 2017, The Annals of Family Medicine.

[6]  Carli Friedman,et al.  The State of Transportation for People With Intellectual and Developmental Disabilities in Medicaid Home and Community-Based Services 1915(c) Waivers , 2016 .

[7]  H. Ouellette-Kuntz,et al.  Systematic Review of the Prevalence and Incidence of Intellectual Disabilities: Current Trends and Issues , 2016, Current Developmental Disorders Reports.

[8]  T. Heller,et al.  Impact of adulthood stage and social-environmental context on body mass index and physical activity of individuals with intellectual disability. , 2015, Intellectual and developmental disabilities.

[9]  S. Meiyappan,et al.  Identification of inappropriate medication use in elderly patients with frequent emergency department visits , 2014, Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC.

[10]  E. Rasch,et al.  Use of emergency departments among working age adults with disabilities: a problem of access and service needs. , 2013, Health services research.

[11]  E John Orav,et al.  Contribution of preventable acute care spending to total spending for high-cost Medicare patients. , 2013, JAMA.

[12]  J. Cairney,et al.  Predictors of emergency department visits by persons with intellectual disability experiencing a psychiatric crisis. , 2012, Psychiatric services.

[13]  S. Larson,et al.  Overweight and obesity among adults with intellectual disabilities who use intellectual disability/developmental disability services in 20 U.S. States. , 2011, American journal on intellectual and developmental disabilities.

[14]  Y. Lunsky,et al.  Emergency Psychiatric Service Use by Individuals With Intellectual Disabilities Living With Family , 2011 .

[15]  L. Ellis,et al.  Comorbidity of intellectual disability and mental disorder in children and adolescents: A systematic review , 2011, Journal of intellectual & developmental disability.

[16]  A. McConnachie,et al.  Neighbourhood deprivation, health inequalities and service access by adults with intellectual disabilities: a cross-sectional study. , 2011, Journal of intellectual disability research : JIDR.

[17]  S. Girdler,et al.  Variation over time in medical conditions and health service utilization of children with Down syndrome. , 2011, The Journal of pediatrics.

[18]  M. Haveman,et al.  Major Health Risks in Aging Persons With Intellectual Disabilities: An Overview of Recent Studies , 2010 .

[19]  Alicia Bazzano,et al.  The Healthy Lifestyle Change Program: a pilot of a community-based health promotion intervention for adults with developmental disabilities. , 2009, American journal of preventive medicine.

[20]  Y. Lunsky,et al.  Emergency Psychiatric Services for Individuals with Intellectual Disabilities: Caregivers’ Perspectives , 2009 .

[21]  A. Jablensky,et al.  Intellectual disability co-occurring with schizophrenia and other psychiatric illness: population-based study , 2008, British Journal of Psychiatry.

[22]  S. Cooper,et al.  Mental ill-health in adults with intellectual disabilities: prevalence and associated factors , 2007, British Journal of Psychiatry.

[23]  G. Dinant,et al.  Health problems of people with intellectual disabilities: the impact for general practice. , 2007, The British journal of general practice : the journal of the Royal College of General Practitioners.

[24]  C. Loh,et al.  A cross-sectional study of the characteristics and determinants of emergency care utilization among people with intellectual disabilities in Taiwan. , 2006, Research in developmental disabilities.

[25]  S. Havercamp,et al.  Health Disparities among Adults with Developmental Disabilities, Adults with other Disabilities, and Adults Not Reporting Disability in North Carolina , 2004, Public health reports.

[26]  E. Emerson.  Prevalence of psychiatric disorders in children and adolescents with and without intellectual disability. , 2003, Journal of intellectual disability research : JIDR.

[27]  P. McCallion,et al.  Health characteristics and health services utilization in older adults with intellectual disability living in community residences. , 2002, Journal of intellectual disability research : JIDR.

[28]  T. Kastner,et al.  Characteristics of hospitalizations for people with developmental disabilities: utilization, costs, and impact of care coordination. , 1997, American journal of mental retardation : AJMR.