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Health characteristics and consultation patterns of people with intellectual disability: a cross-sectional database study in English general practice.

Carey, IM; Shah, SM; Hosking, FJ; DeWilde, S; Harris, T; Beighton, C; Cook, DG (2016) Health characteristics and consultation patterns of people with intellectual disability: a cross-sectional database study in English general practice. British Journal of General Practice (BJGP), 66 (645). pp. 264-270. ISSN 1478-5242
SGUL Authors: Carey, Iain Miller Beighton, Carole Ann

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BACKGROUND: People with intellectual disability (ID) are a group with high levels of healthcare needs; however, comprehensive information on these needs and service use is very limited. AIM: To describe chronic disease, comorbidity, disability, and general practice use among people with ID compared with the general population. DESIGN AND SETTING: This study is a cross-sectional analysis of a primary care database including 408 English general practices in 2012. METHOD: A total of 14 751 adults with ID, aged 18-84 years, were compared with 86 221 age-, sex- and practice-matched controls. Depending on the outcome, prevalence (PR), risk (RR), or odds (OR) ratios comparing patients with ID with matched controls are shown. RESULTS: Patients with ID had a markedly higher prevalence of recorded epilepsy (18.5%, PR 25.33, 95% confidence interval [CI] = 23.29 to 27.57), severe mental illness (8.6%, PR 9.10, 95% CI = 8.34 to 9.92), and dementia (1.1%, PR 7.52, 95% CI = 5.95 to 9.49), as well as moderately increased rates of hypothyroidism and heart failure (PR>2.0). However, recorded prevalence of ischaemic heart disease and cancer was approximately 30% lower than the general population. The average annual number of primary care consultations was 6.29 for patients with ID, compared with 3.89 for matched controls. Patients with ID were less likely to have longer doctor consultations (OR 0.73, 95% CI = 0.69 to 0.77), and had lower continuity of care with the same doctor (OR 0.77, 95% CI = 0.73 to 0.82). CONCLUSION: Compared with the general population, people with ID have generally higher overall levels of chronic disease and greater primary care use. Ensuring access to high-quality chronic disease management, especially for epilepsy and mental illness, will help address these greater healthcare needs. Continuity of care and longer appointment times are important potential improvements in primary care.

Item Type: Article
Additional Information: © British Journal of General Practice 2016. This article is Open Access: CC BY-NC 3.0 license ( licenses/by-nc/3.0/).
Keywords: chronic disease, continuity of care, intellectual disability, learning disabilities, primary care, Public Health, 1117 Public Health And Health Services
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: British Journal of General Practice (BJGP)
ISSN: 1478-5242
Language: ENG
24 February 2016Published
30 July 2015Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 3.0
Project IDFunderFunder ID
12/64/154National Institute for Health Research
PubMed ID: 26906630
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