Service Delivery

Predictors of Emergency Room and Hospital Utilization Among Adults With Intellectual and Developmental Disabilities (IDD).

Blaskowitz et al. (2019) · Intellectual and developmental disabilities 2019
★ The Verdict

Adults with IDD who have multiple chronic conditions or take many meds are the most likely to visit the ER or be hospitalized.

✓ Read this if BCBAs who coordinate care for adults with IDD in community or residential settings
✗ Skip if Clinicians who work only with young children or in countries with universal health care

01Research in Context

01

What this study did

Amaral et al. (2019) looked at health records for adults with intellectual or developmental disabilities.

They wanted to know who lands in the ER or hospital most often.

The team counted chronic illnesses, medicines, living setting, and other health facts.

02

What they found

Older adults with more illnesses, cerebral palsy, mental illness, or many medicines had the most ER trips.

Living in supported living raised ER risk, while living in a group home lowered hospital admission risk.

Age and chronic illness also raised the chance of being admitted to the hospital.

03

How this fits with other research

Sutton et al. (2022) extends these findings by showing adults with ID are admitted from the ER four times more than others.

Patton et al. (2020) zooms in on one cause: medicine errors send adults with IDD to the hospital 28% more often.

Nijs et al. (2016) seems to disagree: in Norway, adults with ID are hospitalized only marginally more than the general public. The gap is smaller there, likely because Norway's health system gives everyone steady primary care.

04

Why it matters

If you serve adults with IDD, flag clients who are older, have multiple diagnoses, or take many meds. These adults are the ones most likely to show up in crisis. Work with nurses and doctors to schedule regular medication reviews and chronic-disease checkups. A five-minute call to the primary-care doctor can replace a five-hour ER wait.

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Review the med list and chronic-disease plan for every adult client over 30.

02At a glance

Intervention
not applicable
Design
other
Sample size
597
Population
intellectual disability, developmental delay
Finding
not reported

03Original abstract

Emergency room (ER) and hospital utilization among people with intellectual and developmental disabilities (IDD) are significant contributors to rising healthcare costs. This study identifies predictors of utilization among 597 adults with IDD. Using a retrospective survey of medical charts, descriptive statistics and logistic regressions were conducted. Individual-level risk factors for ER utilization included age, number of chronic health conditions, a diagnosis of cerebral palsy or neurological disorder, mental illness, and polypharmacy. Environmental predictors included community-based supported living. Hospitalization predictors included age and number of chronic illnesses. People residing in group homes were less likely to be admitted. This study found risk factors unique to individuals with IDD that should be addressed with tailored interventions as states transition to Medicaid managed care.

Intellectual and developmental disabilities, 2019 · doi:10.1352/1934-9556-57.2.127