Community and Hospital Healthcare Use by Adults With and Without Intellectual and Developmental Disabilities in Ontario, Canada, During the First 2 Years of the COVID-19 Pandemic.
Adults with IDD kept using more healthcare than peers through COVID-19, mostly by switching to virtual visits.
01Research in Context
What this study did
The team tracked every doctor, ER, and hospital visit for 64,000 Ontario adults with IDD.
They compared these visits to 1.2 million adults without IDD.
Data ran from 2019 through 2021—covering the first two pandemic years.
What they found
In year one, total visits dropped a large share for everyone.
Virtual visits exploded—from a large share to a large share—and stayed high.
Adults with IDD still used services 1.5 times more than peers in both years.
How this fits with other research
Dudley et al. (2019) warned that most health systems under-count adults with IDD. The Ontario team solved this by linking disability registry files to medical records.
Matson et al. (2009) showed adults with ID already had poor community access pre-COVID. The new data reveal the gap stayed wide even when care moved online.
Yuan et al. (2022) saw Chinese kids with ID lose almost all physical-activity services. Ontario adults kept higher use—likely because Canada kept funding virtual care.
Why it matters
Your clients already use more healthcare, and tele-health is here to stay. Check if virtual portals are accessible—large buttons, plain language, caregiver log-ins. Schedule shorter, more frequent e-visits to keep people engaged and catch problems early.
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02At a glance
03Original abstract
BACKGROUND: This study describes the proportion of Ontario adults with and without intellectual and developmental disabilities (IDD) who used community- and hospital-based healthcare in the first 2 years of the pandemic compared with the year pre-COVID-19. METHODS: Linked health administrative databases identified 87 341 adults with IDD and also adults without IDD living in Ontario, Canada. For each cohort, counts and proportions of adults who used different types of healthcare services were reported for the pre-COVID-19 year (16 March 2019 to 14 March 2020) and the first two COVID-19 years (15 March 2020 to 14 March 2021 and 15 March 2021 to 14 March 2022). RESULTS: Compared with the year prior to COVID-19, the proportion of adults with and without IDD who used health services was lower during the first COVID-19 year, but the likelihood of all types of visits increased during the second year. The likelihood of using homecare and of being hospitalized nearly returned to pre-pandemic levels. Virtual physician visits increased in each COVID-19 year from 5.2% prior to the pandemic to 13.0% in year 1 and 58.7% in year 2. For all years, the proportion of adults who used each service type was higher for those with IDD than without IDD. CONCLUSIONS: For adults with and without IDD in Ontario, Canada, during the first two COVID-19 years healthcare use decreased for all service types, except for virtual physician visits. In the second year, healthcare use increased but did not reach pre-COVID-19 levels. In all years, adults with IDD were more likely to use services than other adults.
Journal of intellectual disability research : JIDR, 2025 · doi:10.1111/jir.13209