Williams Jeremy M, Coxen Kendyll, Palacio Carlos, Jacob Rafik
Internal Medicine, University of Florida College of Medicine, Jacksonville, USA.
Emergency Medicine, University of Florida College of Medicine, Gainesville, USA.
Cureus. 2025 Apr 3;17(4):e81667. doi: 10.7759/cureus.81667. eCollection 2025 Apr.
Adults with intellectual and developmental disabilities (IDD) experience higher rates of emergency department (ED) utilization compared to the general population due to complex medical needs, healthcare access barriers, and social determinants of health. Although prior research has identified predictors of ED use, including socioeconomic status, primary care continuity, and housing stability, the role of specialized primary care programs in reducing reliance on emergency services remains understudied. This study examines the impact of the Program for Adults With Intellectual and Developmental Disabilities (PAIDD) at the University of Florida (UF) Health Jacksonville on ED utilization rates among adults with IDD. Using a retrospective cohort design, we compared ED visit frequencies between PAIDD patients and a control group of adults with IDD who receive care outside the program. Additionally, we explored whether housing status, living with family, independently, or in a facility, affects ED utilization. Findings revealed a statistically significant reduction in ED visits among PAIDD patients compared to the control group (p=0.004), suggesting that structured, multidisciplinary healthcare models improve continuity of care and reduce avoidable ED utilization. However, housing status alone did not emerge as an independent predictor of ED use (p=0.093), indicating that other factors, such as access to primary care and caregiver support, may play a greater role. These results underscore the need for expanded university-based IDD healthcare programs to bridge gaps in care, enhance preventive health strategies, and reduce emergency healthcare dependence in this population. The study supports the integration of dedicated IDD clinics in academic medical centers to improve long-term health outcomes and health equity for individuals with IDD.
与普通人群相比，患有智力和发育障碍（IDD）的成年人由于复杂的医疗需求、医疗保健获取障碍以及健康的社会决定因素，急诊部门（ED）的使用率更高。尽管先前的研究已经确定了急诊使用的预测因素，包括社会经济地位、初级保健连续性和住房稳定性，但专门的初级保健项目在减少对急诊服务依赖方面的作用仍未得到充分研究。本研究考察了佛罗里达大学杰克逊维尔分校（UF Health Jacksonville）的智力和发育障碍成人项目（PAIDD）对IDD成年人急诊使用率的影响。采用回顾性队列设计，我们比较了PAIDD患者与该项目外接受治疗的IDD成年对照组的急诊就诊频率。此外，我们还探讨了住房状况，即与家人同住、独立居住或住在机构中，是否会影响急诊使用情况。研究结果显示，与对照组相比，PAIDD患者的急诊就诊次数有统计学意义的减少（p = 0.004），这表明结构化的多学科医疗模式可改善医疗连续性并减少可避免的急诊使用。然而，单独的住房状况并未成为急诊使用的独立预测因素（p = 0.093），这表明其他因素，如获得初级保健和护理人员支持，可能发挥更大作用。这些结果强调了扩大基于大学的IDD医疗项目的必要性，以弥合护理差距、加强预防保健策略并减少该人群对急诊医疗的依赖。该研究支持在学术医疗中心整合专门的IDD诊所，以改善IDD患者的长期健康结果和健康公平性。
