Rocco Friebel (
Laia Maynou, Universitat de Barcelona, Barcelona, Spain; London School of Economics and Political Science; and CRES-Universitat Pompeu Fabra, Barcelona.
Health Aff (Millwood). 2022 Oct;41(10):1486-1495. doi: 10.1377/hlthaff.2022.00493.
People with developmental disability have higher health care needs and lower life expectancy compared with the general population. Poor quality of care resulting from interpersonal and systemic discrimination may further entrench existing inequalities. We examined the prevalence of five avoidable in-hospital patient safety incidents (adverse drug reactions, hospital-acquired infections, pressure ulcers, postoperative pulmonary embolism or deep vein thrombosis, and postoperative sepsis) for four developmental disability groups (people with intellectual disability, chromosomal abnormalities, pervasive developmental disorders, and congenital malformation syndrome) in the English National Health Service during the period April 2017-March 2019. We found that the likelihood of experiencing harm in disability groups was up to 2.7-fold higher than in patients without developmental disability. Patient safety incidents led to an excess length-of-stay in hospital of 3.6-15.4 days and an increased mortality risk of 1.4-15.0 percent. We show persisting quality differences in patients with developmental disability, requiring an explicit national policy focus on the needs of such patients to reduce inequalities, reach parity of care, and lower the burden on health system resources.
与一般人群相比，发育障碍患者的医疗保健需求更高，预期寿命更短。人际和系统歧视导致的护理质量低下可能会进一步加剧现有的不平等。我们研究了在 2017 年 4 月至 2019 年 3 月期间，英国国家医疗服务体系中四个发育障碍群体（智力障碍、染色体异常、广泛性发育障碍和先天性畸形综合征）的五种可避免的住院患者安全事件（药物不良反应、医院获得性感染、压疮、术后肺栓塞或深静脉血栓形成和术后败血症）的发生率。我们发现，在残疾群体中经历伤害的可能性高达无发育障碍患者的 2.7 倍。患者安全事件导致住院时间延长 3.6-15.4 天，死亡率增加 1.4-15.0%。我们发现，发育障碍患者的护理质量仍存在差异，这需要国家明确关注此类患者的需求，以减少不平等，实现护理均等化，并降低卫生系统资源的负担。
