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Emergency Department Use: Common Presenting Issues and Continuity of Care for Individuals With and Without Intellectual and Developmental Disabilities

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Abstract

This population-based cohort study examined the relationship between level of continuity of primary care and subsequent emergency department (ED) visits for adults with (n = 66,484) and without intellectual and developmental disabilities (IDD)(n = 2,760,670). Individuals with IDD were more likely than individuals with no IDD to visit the ED (33.96% versus 20.28%, p < 0.0001). For both groups receiving greater continuity of primary care was associated with less ED use, but this relationship was more marked for adults with IDD. While continuity of primary care can reduce ED use for populations with and without IDD, it is a higher priority for individuals with IDD whose cognitive and adaptive impairments may complicate help-seeking, diagnosis, and treatment. Improving primary care can have far-reaching implications for this complex population.

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Acknowledgments

This paper is part of the Health Care Access Research and Developmental Disabilities (H-CARDD) Program. This paper was supported by a Partnerships in Health Systems Improvement grant (PHE #103973) from the Canadian Institutes of Health Research (CIHR) using data provided by the Ontario Ministry of Health and Long-Term Care (MOHLTC), and the Ontario Ministry of Community and Social Services (MCSS), to the Institute for Clinical Evaluative Sciences (ICES). The opinions, results and conclusions reported in this paper are those of the authors and do not necessarily represent the funding sources and data providers. No endorsement by the CIHR, MOHLTC, MCSS or ICES is intended or should be inferred. Parts of this material are based on data and information compiled and provided by the Canadian Institute for Health Information (CIHI). However, the analyses, conclusions, opinions and statements expressed herein are those of the author, and not necessarily those of CIHI. The Johns Hopkins ACG® system Version 10 was used for the research.

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Authors and Affiliations

  1. Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, M5B 1T8, Canada

    Anna Durbin

  2. Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, L1H 7K4, Canada

    Robert Balogh

  3. Provincial System Support Program, Centre for Addiction and Mental Health, Toronto, ON, M5S 2S1, Canada

    Elizabeth Lin

  4. Institute for Clinical Evaluative Sciences, Toronto, ON, M4N 3M5, Canada

    Anna Durbin, Robert Balogh, Elizabeth Lin, Andrew S. Wilton & Yona Lunsky

  5. Adult Neurodevelopmental Services, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H4, Canada

    Yona Lunsky

  6. Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada

    Anna Durbin, Elizabeth Lin & Yona Lunsky

Authors
  1. Anna Durbin
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  2. Robert Balogh
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  3. Elizabeth Lin
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  4. Andrew S. Wilton
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  5. Yona Lunsky
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Contributions

AD wrote the first draft of the manuscript. ASW conducted the analysis. RB, EL and YL assisted with all parts of the manuscript preparation, including reviewing the final manuscript draft.

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Correspondence to Anna Durbin.

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All authors declare that they have no conflicts of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Durbin, A., Balogh, R., Lin, E. et al. Emergency Department Use: Common Presenting Issues and Continuity of Care for Individuals With and Without Intellectual and Developmental Disabilities. J Autism Dev Disord 48, 3542–3550 (2018). https://doi.org/10.1007/s10803-018-3615-9

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  • DOI: https://doi.org/10.1007/s10803-018-3615-9

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