Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute-University of Queensland (MRI-UQ), South Brisbane, Queensland, Australia.
Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia.
J Appl Res Intellect Disabil. 2022 Nov;35(6):1403-1417. doi: 10.1111/jar.13029. Epub 2022 Aug 23.
In a cohort of adults with intellectual disability who were followed for up to 16-years, we investigated characteristics associated with frequent emergency department (ED) presentations, hospitalisation, and psychiatric care.
Community-dwelling adults with intellectual disability residing in Queensland, Australia, were followed from 1999 to 2015. Healthcare presentations were extracted from administrative databases. Adults who presented frequently were identified and characteristics associated with frequent presentations were identified.
Data from 445 adults were analysed. Chronic disease and challenging behaviour were associated with frequent ED presentations (adjusted odds ratio = 1.8, 95% confidence interval = 1.1-3.0 and aOR = 2.2, 95% CI = 1.2-3.9 respectively). Chronic disease and severe/profound intellectual disability were associated with frequent hospitalisations (aOR = 1.9, 95% CI = 1.2-3.2 and aOR = 2.0, 95% CI = 1.2-3.3 respectively). Psychotropic medication use was associated with frequent psychiatric presentations (aOR = 1.9, 95% CI = 1.0-3.4).
Adults at high risk of frequent healthcare presentations should be identified for programmes of optimising health system use, and potentially improving health care quality.
在一项对多达 16 年进行随访的智障成年人队列研究中，我们调查了与频繁急诊就诊、住院和精神科护理相关的特征。
澳大利亚昆士兰州的社区居住智障成年人从 1999 年至 2015 年进行了随访。从管理数据库中提取医疗保健就诊记录。确定经常就诊的成年人，并确定与频繁就诊相关的特征。
分析了 445 名成年人的数据。慢性疾病和行为挑战与频繁的急诊就诊相关（调整后的优势比=1.8，95%置信区间=1.1-3.0 和 aOR=2.2，95%CI=1.2-3.9）。慢性疾病和严重/极重度智力残疾与频繁住院相关（aOR=1.9，95%CI=1.2-3.2 和 aOR=2.0，95%CI=1.2-3.3）。精神科药物使用与频繁精神科就诊相关（aOR=1.9，95%CI=1.0-3.4）。
应确定高风险频繁就诊的成年人，以优化卫生系统使用方案，并可能提高医疗保健质量。
