Preventable Emergency Hospital Admissions Among Adults With Intellectual Disability in England.

Area of Science:

• Public Health
• Health Services Research
• Intellectual Disabilities Research

Background:

• Adults with intellectual disabilities (ID) experience significant health disparities and poorer healthcare quality.
• There is a critical need to understand and reduce emergency hospital admissions in this vulnerable population.

Purpose of the Study:

• To compare overall and preventable emergency admissions between adults with and without ID in England.
• To assess primary care management of ambulatory care-sensitive conditions (ACSCs) before admission in adults with ID.

Main Methods:

• A cohort study using electronic records of 16,666 adults with ID and 113,562 matched controls from 343 English practices.
• Conditional Poisson regression analyzed emergency admission rates; unmatched analysis compared primary care management for lower respiratory and urinary tract infections.

Main Results:

• Adults with ID had 2.82 times higher overall emergency admission rates (182 vs 68 per 1,000/year).
• ACSCs accounted for 33.7% of admissions in adults with ID vs 17.3% in controls (IRR=5.62), with risk persisting after adjustments.
• Despite higher risk for specific infections, primary care use and management were similar between groups.

Conclusions:

• Adults with intellectual disabilities are at a substantially higher risk for preventable emergency hospital admissions.
• Enhanced primary care strategies for early detection and management of ACSCs, such as respiratory and urinary tract infections, are essential to reduce hospitalizations.