Mental Health and Wellbeing Research Group, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
J Appl Res Intellect Disabil. 2018 Jan;31 Suppl 1:68-81. doi: 10.1111/jar.12386. Epub 2017 Jul 20.
In the UK, general practitioners/family physicians receive pay for performance on management of long-term conditions, according to best-practice indicators.
Management of long-term conditions was compared between 721 adults with intellectual disabilities and the general population (n = 764,672). Prevalence of long-term conditions was determined, and associated factors were investigated via logistic regression analyses.
Adults with intellectual disabilities received significantly poorer management of all long-term conditions on 38/57 (66.7%) indicators. Achievement was high (75.1%-100%) for only 19.6% of adults with intellectual disabilities, compared with 76.8% of the general population. Adults with intellectual disabilities had higher rates of epilepsy, psychosis, hypothyroidism, asthma, diabetes and heart failure. There were no clear associations with neighbourhood deprivation.
Adults with intellectual disabilities receive poorer care, despite conditions being more prevalent. The imperative now is to find practical, implementable means of supporting the challenges that general practices face in delivering equitable care.
在英国，全科医生/家庭医生根据最佳实践指标，因管理长期疾病而获得绩效薪酬。
在 721 名智力残疾成年人和普通人群（n=764672）之间比较了长期疾病的管理情况。通过逻辑回归分析确定了长期疾病的患病率，并调查了相关因素。
在 57 项指标中的 38 项（66.7%）指标上，智力残疾成年人的长期疾病管理明显较差。只有 19.6%的智力残疾成年人达到了很高的（75.1%-100%）达标率，而普通人群的这一比例为 76.8%。智力残疾成年人癫痫、精神病、甲状腺功能减退、哮喘、糖尿病和心力衰竭的发病率更高。与社区贫困程度没有明显关联。
尽管智力残疾成年人的疾病更为普遍，但他们接受的护理较差。现在的当务之急是找到切实可行的方法来支持全科医生在提供公平护理方面面临的挑战。
