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Health Service Utilization Patterns Among Medicaid-Insured Adults With Intellectual and Developmental Disabilities:
Emily Lauer1, Scott Lindgren, Elizabeth Momany
1Center for Developmental Disabilities Evaluation and Research (CDDER), Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Worcester (Ms Lauer); Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City (Dr Lindgren); University of Iowa Public Policy Center, Iowa City (Dr Momany); New York State Department of Health, Office of Quality and Patient Safety, Division of Information and Statistics, Albany (Ms Cope); South Carolina Revenue and Fiscal Affairs Office, Health and Demographics Section, Columbia (Ms Royer); New York State Department of Health, Office of Quality and Patient Safety, Division of Quality Measurement, Albany (Dr Cogan); Arnold School of Public Health, University of South Carolina, Columbia (Dr McDermott); and Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Armour).
Abstract:
Limited existing evidence suggests that adults with intellectual and developmental disabilities (IDD) experience substantial disparities in numerous areas of health care, including quality ambulatory care. A multistate cohort of adults with IDD was analyzed for patterns of inpatient admissions and emergency department utilization. Utilization was higher (inpatient [RR = 3.2], emergency department visits [RR = 2.6]) for adults with IDD, particularly for ambulatory care-sensitive conditions (eg, urinary tract [RR = 6.6] and respiratory infections [RRs = 5.5-24.7]), and psychiatric conditions (RRs = 5.8-15). Findings underscore the importance of access to ambulatory care skilled in IDD-related needs to recognize and treat ambulatory care-sensitive conditions and to manage chronic medical and mental health conditions.
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