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Intellectual disability (ID) is a neurodevelopmental condition characterized by deficits in intellectual and adaptive functioning that manifest during the developmental period. This condition encompasses challenges in reasoning, memory, problem-solving, and learning, accompanied by impairments in everyday life skills, such as communication, self-care, and social interactions. Intellectual disability affects approximately 1% of the population in the United States, impacting an estimated 5...
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A Consultation Model for Intellectual and Developmental Disability Care.

Rebecca T Putnam1, Phillip M Hughes2, Chelsea C Atkins2

  • 1From the Department of Family Medicine, Mountain Area Health Education Center, Asheville, NC (RTP); Department of Research, UNC Health Sciences at MAHEC, Asheville, NC (PMH, CCA, CMB); Division of Pharmaceutical Outcomes & Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC (PMH); Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC (PMH). rebecca.putnam@mahec.net).

Journal of the American Board of Family Medicine : JABFM
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PubMed
Summary

This study highlights a consultative care model for patients with Intellectual and Developmental Disabilities (IDD), showing it serves a diverse population, including those in rural areas, improving healthcare access.

Keywords:
Access to CareAutism Spectrum DisordersIntellectual DisabilityInterdisciplinary Health TeamOrganizational InnovationPopulation HealthPractice-based ResearchPrimary Health CareQuality of CareReferral and ConsultationRetrospective StudiesSpatial AnalysisVulnerable Populations

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Area of Science:

  • Family Medicine
  • Intellectual and Developmental Disabilities (IDD)
  • Healthcare Access

Background:

  • Patients with Intellectual and Developmental Disabilities (IDD) often face challenges accessing specialized healthcare services.
  • A consultative care model integrated within Family Medicine can potentially bridge these gaps.

Purpose of the Study:

  • To evaluate an innovative consultative care model for patients with Intellectual and Developmental Disabilities (IDD) within a Family Medicine setting.
  • To characterize the patient population, their needs, and geographic distribution served by this model.

Main Methods:

  • Retrospective chart review of 184 patients with IDD from 2017-2023.
  • Analysis of patient demographics, diagnoses, insurance status (Medicaid), living arrangements, and guardianship.
  • Spatial analysis to determine travel distance and time to the clinic.

Main Results:

  • The patient cohort (n=184) was predominantly male (65%), with a mean age of 31.29 years.
  • Over half were insured by Medicaid (65%), with many utilizing state Medicaid waivers (43%).
  • Most patients resided in nonrural areas, traveling an average of 20.41 miles and 27.08 minutes; 38% received referrals to services like psychiatry and neurology.

Conclusions:

  • The consultative care model effectively serves a diverse IDD patient population with varied needs.
  • This model appears to enhance healthcare access for individuals with IDD across a broad geographic area, potentially reaching underserved populations.