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Health inequities in unscheduled healthcare for children with intellectual disabilities in Ireland: a study protocol
Emma Nicholson1, Edel Doherty2, Suja Somanadhan3
1Centre for Interdisciplinary Research, Education and Innovation in Health Systems (IRIS), University College Dublin, Belfield, Dublin 4, Ireland.
Insights
Children with intellectual disabilities face significant health inequities, including higher hospitalization rates. This study investigates these disparities in Ireland to inform policy and improve equitable healthcare access for children with intellectual disabilities.
Area of Science:
- Health Services Research
- Pediatric Health
- Disability Studies
Background:
- Children with intellectual disabilities experience significant health inequities, including reduced life expectancy and higher rates of preventable hospitalizations.
- Existing research highlights these disparities but lacks evidence-based strategies to address them within health systems.
- A health systems approach is crucial for developing policies and practices that ensure equitable healthcare for individuals with intellectual disabilities.
Purpose of the Study:
- To determine the extent of health inequities for children with intellectual disabilities in Ireland compared to their peers.
- To understand the factors influencing primary care and emergency department service utilization in this population.
- To develop feasible solutions and interventions to address identified healthcare inequities.
Main Methods:
- Multi-methods research design combining statistical analysis of health data.
- Discrete choice experiments to assess General Practitioners' decision-making and parental preferences.
- Concept mapping to achieve stakeholder consensus on addressing healthcare inequities.
Main Results:
- Statistical analysis will quantify health inequities in healthcare utilization.
- Discrete choice experiments will reveal influences on service provision and patient choice.
- Concept mapping will identify consensus-driven interventions for equitable care.
Conclusions:
- Applying a systems lens is vital for understanding and addressing the multifaceted nature of health inequities.
- This research aims to provide practical, evidence-based solutions for improving healthcare equity for children with intellectual disabilities.
- The findings will inform policy and practice to ensure equitable healthcare access and outcomes.
Abstract:
Background: Health inequities for children with intellectual disabilities are prevalent within different health systems, and children with intellectual disabilites have shorter life expectancies than the general population, higher mortality rates before the age of 17 and have a greater risk of potentially preventable hospitalisations. A health systems approach to research in this area provides a useful means through which research can inform policy and practice to ensure people with intellectual disabilities receive equitable healthcare; however, there is a paucity of evidence regarding how to address differences that have been described in the literature to date. The overall aim of this research is to establish the extent of health inequities for children with intellectual disabilities in Ireland compared to children without intellectual disabilities with respect to their utilisation of primary care and rates of hospitalisation, and to gain a better understanding of what influences utilisation of primary care and emergency department services in this population. Methods and analysis: The design of this research adopts a multi-methods approach: statistical analysis of health data to determine the extent of health inequities in relation to healthcare utilisation; discrete choice experiments to explore General Practitioners' decision making and parental preferences for optimal care; and concept mapping to develop consensus between stakeholders on how to address current healthcare inequities. Discussion: By applying a systems lens to the issue of health inequities for children with intellectual disabilities, the research hopes to gain a thorough understanding of the varying components that can contribute to the maintenance of such healthcare inequities. A key output from the research will be a set of feasible solutions and interventions that can address health inequities for this population.
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