People with intellectual disability in general practice: case definition and case finding.
Ask GPs to use ICPC codes for ID so medical records show who needs extra time and support.
01Research in Context
What this study did
Doctors in the UK looked at computer records from 43 family practices. They wanted to know how many patients had intellectual disability and how the diagnosis was noted.
What they found
Only 0.82 % of patients carried an ID code. For most of them the file did not say the cause, the level of disability, or what help they needed at home.
Records that used the ICPC coding system were clearer and easier to search.
How this fits with other research
Later work shows the same small group still gets poor care. Faso et al. (2016) found Australians with ID visit the GP less often for check-ups and shots. McConkey et al. (2010) show these gaps lead to six times more avoidable hospital stays.
Two 1997 GP surveys help explain why. Christian et al. (1997) report doctors accept medical duty but resist extra screening tasks. Smith et al. (1997) add that communication problems and short visits block good care.
The 0.82 % figure lines up with Pitetti et al. (2007), who saw 0.70 % in Finnish national registers, giving confidence the number is real.
Why it matters
If you support adults with ID, ask the GP to add the ICPC code to the file. A simple flag makes it easier to track health needs, book longer appointments, and close the care gaps that later send people to hospital.
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02At a glance
03Original abstract
In a general practice database containing data on 62,000 patients, those with intellectual disability (ID) were traced. Health problems in this database were recorded according to the International Classification of Health Problems in Primary Care (ICPC) code. By using selected codes, 318 people with ID (0.65% of the study population) were found; the sample contained nearly as many false positives. Adding up the percentage of people with ID living in residential facilities, the total prevalence of people with ID was estimated as 0.82%. Documentation on the cause and level of ID was available in about half of the cases. The demographic characteristics of the people with ID were significantly different from the general population: there was a higher percentage of males and a lower percentage of people over 50 years of age among those with ID. Information about the use of home care was virtually non-existent in the general practice data. The results are compared with those of other studies. The discussion deals with reasons for complete documentation of cases with ID in general practice and the role of the general practitioner in health care supply to people with ID.
Journal of intellectual disability research : JIDR, 1997 · doi:10.1111/j.1365-2788.1997.tb00724.x