Kreps Felicia, Wijekulasuriya Shalini, Zurynski Yvonne, Mitchell Rebecca
Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
J Intellect Disabil Res. 2025 Aug 25. doi: 10.1111/jir.70033.
Young people with intellectual disability may exhibit poorer general health, higher mortality rates and greater limitations from physical or mental illnesses compared to the general population. It is important to understand how this may relate to healthcare utilisation, including factors influencing healthcare access for young people with intellectual disability. This systematic review aimed to examine healthcare utilisation and to identify common barriers and facilitators of healthcare access for young people with intellectual disability.
Five databases (MEDLINE, Scopus, EMBASE, PsycINFO and CINAHL) were searched from 1 January 2013 to 31 October 2024 to identify articles that examined healthcare utilisation for young people (≤ 18 years old) with intellectual disability. Abstract and full-text screening were conducted by two reviewers; data from included articles were critically appraised.
Thirty-three studies were included for synthesis and focused on utilisation of hospital inpatient services (n = 22), emergency department (ED) services (n = 13), mental health or psychiatric services (n = 7) and mental health day programmes or outreach services (n = 1). Young people with intellectual disability generally had a higher proportion of hospital admissions, ED visits, hospital length of stay, mental health outpatient visits, mortality, 30-day hospital readmission and complications of care, compared to young people without intellectual disability. Common facilitators of healthcare access and engagement included having health insurance coverage and the use of visual aids and tools for the young person with intellectual disability. Barriers included low socio-economic status and poor provider communication and knowledge about intellectual disability.
There are clear disparities in health service outcomes for young people with intellectual disability compared to the general population, which may be influenced by socio-cultural factors and access to knowledgeable and empathetic healthcare providers. Targeted education for healthcare providers may enhance the provision of high-quality care and improve healthcare utilisation and health outcomes for young people with intellectual disability.
与普通人群相比，智障青年可能总体健康状况较差、死亡率较高，且因身体或精神疾病而受到的限制更大。了解这与医疗保健利用之间的关系很重要，包括影响智障青年获得医疗保健的因素。本系统评价旨在研究医疗保健利用情况，并确定智障青年获得医疗保健的常见障碍和促进因素。
检索了五个数据库（MEDLINE、Scopus、EMBASE、PsycINFO和CINAHL），检索时间为2013年1月1日至2024年10月31日，以确定研究智障青年（≤18岁）医疗保健利用情况的文章。由两名评审员进行摘要和全文筛选；对纳入文章的数据进行严格评估。
纳入33项研究进行综合分析，重点关注医院住院服务（n = 22）、急诊科（ED）服务（n = 13）、心理健康或精神科服务（n = 7）以及心理健康日间项目或外展服务（n = 1）的利用情况。与非智障青年相比，智障青年的住院率、急诊就诊率、住院时间、心理健康门诊就诊率、死亡率、30天再住院率和护理并发症比例普遍较高。获得医疗保健和参与医疗保健的常见促进因素包括有医疗保险覆盖，以及为智障青年使用视觉辅助工具。障碍包括社会经济地位低，以及医疗服务提供者沟通不良和对智障缺乏了解。
与普通人群相比，智障青年的卫生服务结果存在明显差异，这可能受到社会文化因素以及是否能获得知识渊博且富有同情心的医疗服务提供者的影响。对医疗服务提供者进行有针对性的教育，可能会提高为智障青年提供的高质量护理水平，改善医疗保健利用情况和健康结果。
