A prospective study of hospital episodes of adults with intellectual disability.
Adults with ID return to the hospital fast—plan their exit the moment they arrive.
01Research in Context
What this study did
Kovačič et al. (2020) followed adults with intellectual disability for 35 months. They counted every emergency visit and hospital stay.
The team tracked how soon each person came back after discharge.
What they found
Each adult averaged 1.3 hospital episodes. More than half returned within 30 days.
The pattern shows heavy, repeated use of acute-care services.
How this fits with other research
Nijs et al. (2016) saw a different picture in Norway. Hospital use there was almost the same as the general population. The gap between Norway and Australia likely comes from different discharge rules and community supports.
Sutton et al. (2022) later showed U.S. adults with ID are admitted from the ED four times more often than others. This backs up the high-use pattern T et al. first measured.
Schroeder et al. (2014) and Doughty et al. (2015) add that when adults with ID are admitted, they stay longer and face more complications. The story is consistent: heavy use plus higher risk once inside.
Why it matters
You can flag adults with ID at intake. Start discharge planning on day one. Book follow-up within a week, check medication lists, and teach caregivers red-flag symptoms. These steps can cut the 30-day return rate and keep people safe at home.
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02At a glance
03Original abstract
BACKGROUND: Previous research has shown poor hospital experiences and dire outcomes for people with intellectual disability. The main objective of this study was to prospectively track episodes for adults with intellectual disability (ID) in Australian hospitals, with a focus on indications of the quality of care provided. METHODS: A prospective audit of hospital records over 35 months yielded quantitative data about patient characteristics, frequency and length of hospital episodes, diagnostic assessments and outcomes, post-emergency department (ED) destinations and post-discharge recommendations. Fifty participants were recruited largely by identification on hospital ED entry. An audit of patients' hospital records was conducted towards the end of hospital episodes, using a tool developed for the study. RESULTS: Participants were mostly men (70%), aged 42.9 years on average, living mostly with family (46%) or in supported accommodation (44%). Of 157 recorded episodes, 96% started in ED, 85% required urgent or semi-urgent care and 62% were in the first 3 months of study participation. Average time in ED exceeded the 4-h national benchmark, met in 40% of episodes. One or more diagnostic assessments were conducted in 91% episodes and others in short stay units. Almost half (49%) resulted in a ward stay. With an extreme data point removed, <1-35 days were spent in wards. The most frequent diagnosis in 75% of episodes was for digestive problems, followed by nervous system problems then injuries. Median length of bed stays reflected data available for Australian refined diagnosis-related groups. High hospital re-presentations were found: for 67% of episodes in total, 26% (n = 12) of which were within 72 h and 59% (n = 23) within 30 days. CONCLUSIONS: Adults with ID presented frequently to ED and often had lengthy stays. We found no indication of poor care practices in terms of hospital staff willingness to keep patients in ED and conduct of diagnostic assessments. Frequent re-presentations, however, indicated failed hospital care at some level.
Journal of intellectual disability research : JIDR, 2020 · doi:10.1111/jir.12725