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

Anna Durbin; Robert Balogh; Elizabeth Lin; Andrew S Wilton; Yona Lunsky

doi:10.1007/s10803-018-3615-9

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

J Autism Dev Disord. 2018 Oct;48(10):3542-3550. doi: 10.1007/s10803-018-3615-9.

Authors

Anna Durbin^{1

2

3}, Robert Balogh^{4

5}, Elizabeth Lin^{6

5

7}, Andrew S Wilton⁵, Yona Lunsky^{5

8

7}

Affiliations

¹ Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, M5B 1T8, Canada. durbinan@smh.ca.
² Institute for Clinical Evaluative Sciences, Toronto, ON, M4N 3M5, Canada. durbinan@smh.ca.
³ Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada. durbinan@smh.ca.
⁴ Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, L1H 7K4, Canada.
⁵ Institute for Clinical Evaluative Sciences, Toronto, ON, M4N 3M5, Canada.
⁶ Provincial System Support Program, Centre for Addiction and Mental Health, Toronto, ON, M5S 2S1, Canada.
⁷ Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada.
⁸ Adult Neurodevelopmental Services, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H4, Canada.

PMID: 29923146
DOI: 10.1007/s10803-018-3615-9

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.

Keywords: Continuity of care; Developmental disabilities; Emergency department; Intellectual disabilities; Primary care; Primary care physicians.

MeSH terms

Adolescent
Adult
Cohort Studies
Continuity of Patient Care / statistics & numerical data*
Developmental Disabilities / epidemiology
Developmental Disabilities / therapy*
Emergency Service, Hospital / statistics & numerical data*
Female
Humans
Intellectual Disability / epidemiology
Intellectual Disability / therapy*
Male
Middle Aged
Primary Health Care / statistics & numerical data