Causes of death of persons with developmental disabilities: comparison of institutional and community residents.

Between 1993 and 1995, 1,878 persons transferred from California institutions into the community. By early 1996, 45 had died--significantly more than expected (Strauss, Shavelle, Baumeister, and Anderson, 1998). We report here on the death certificates for this group, using a comparison group of 45 certificates for institutional residents. Thirty-two of the community deaths versus 10 of the institution deaths were "sudden" or "subacute." All of the institution deaths versus 79% of the community deaths were reported to the coroner, and 55% of the institutional deaths were followed by autopsy compared to 33% in the community. Six deaths were due to perforated bowels, 5 of which were in individuals residing in the community.