Good primary care lowers emergency department use for those with intellectual and developmental disabilities

One in three adults with intellectual and developmental disabilities (IDD) visit the emergency department annually but effective primary care could reduce these numbers, suggests a new study led by St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences (ICES).

“For populations with IDD, the emergency department can be a frustrating and overwhelming place,” said Dr. Anna Durbin, scientist at the Li Ka Shing Knowledge Institute of St. Michael’s and lead author of the study. “Many people with IDD — about 88 per cent — are already accessing some form of primary care and it’s a great way to reach them. What can we do during these visits to prevent potentially difficult experiences in the emergency room?”

Diagnoses of IDD include Down syndrome, fetal alcohol spectrum disorder, autism and other pervasive developmental disorders, all presenting with adaptive behaviour deficits. Using administrative health databases combined with disability income support records, the research team studied the data of 66,464 adults aged 18-64 in Ontario with IDD, and compared the numbers to a random sample of about two million Ontarians without IDD. Researchers found that those with IDD were almost 1.5 times more likely to visit the emergency department. The study also found that the proportion of emergency department visits due to psychiatric issues was at least double for patients with IDD than for those without IDD.

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