Longitudinal analysis of inpatient care utilization among people with intellectual disabilities: 1999-2002.
Adults with ID in institutions are hospitalized far more often than the general public—watch them closely for pneumonia, GI issues, and seizures.
01Research in Context
What this study did
The team tracked every hospital stay for adults with intellectual disability in Taiwan from 1999 to 2002. They used national insurance records to see who went in and why. The focus was on people living in large residential centers.
What they found
One in ten residents landed in the hospital each year. Pneumonia, stomach problems, and seizures topped the list. Living in an institution, having cerebral palsy, and using lots of outpatient care raised the odds.
How this fits with other research
Lai et al. (2011) dug deeper into the same data set. They found that adding schizophrenia doubled both cost and length of stay. The 2007 paper set the baseline; the 2011 paper showed how one extra diagnosis explodes the bill.
McConkey et al. (2010) looked at Canada and saw a six-fold jump in preventable hospital days for people with ID. C-Pitetti et al. (2007) reported a smaller bump in Taiwan. The gap looks like a contradiction, but the two studies counted different things. C-H counted all stays; R counted only stays that good primary care should prevent. Both agree: people with ID land in the hospital too often.
Yen et al. (2009) carried the story forward. After 2002, institutional use kept climbing. The 2007 paper captured the first wave; the 2009 paper showed the wave never broke.
Why it matters
If you serve adults with ID in any setting, treat institutional placement as a red flag for health risk. Build nurse-led screens for pneumonia, GI distress, and seizures into the care plan. Partner with primary care to catch problems early and keep beds open for kids who need them.
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02At a glance
03Original abstract
BACKGROUND: There has been no longitudinal study in Taiwan to identify the nature and the scale of medical care utilization of people with intellectual disabilities (IDs) up to the present. The aim of this study is to describe inpatient utilization among people under ID care in institutions in order to identify the pattern of medical care needs and the factors affecting utilization in Taiwan. METHOD: The subject cohort was 168 individuals with ID who were cared for by a large public disability institution from 1999 to 2002 in Taipei, Taiwan. RESULTS: On the examination of the inpatient care that these persons underwent, it was found that these individuals had a heightened need (inpatient rate: 10.1-14.9%) for inpatient care compared with the general population with disabilities (9.37%) in Taiwan. The main reasons for hospitalization were pneumonia, gastrointestinal disorders, cellulites, orthopaedic problems, epilepsy and bronchitis. Using the full model of Generalized Estimating Equations for inpatient care utilization, the factors including low income family, living in an institution, being a subject with cerebral palsy and being a high outpatient user all influenced the use of inpatient care. CONCLUSIONS: This study highlights that health authorities need to promote health planning more in order to ensure an excellent quality of health monitoring and health promotion among people with ID cared for by institutions.
Journal of intellectual disability research : JIDR, 2007 · doi:10.1111/j.1365-2788.2006.00822.x