Thirty six percent of hospitalizations among adults with ID caused by five health conditions

Sarah Ailey

By Sarah Ailey, PhD
Rush University

Individuals with intellectual disability (ID) often have multiple chronic conditions and complex health care needs. Rates of hospitalization among individuals with ID are high for ambulatory-sensitive conditions and in general (even when they are in formal community care systems).

What did you do in your research?
We analyzed hospitalization data from the UHC (formerly known as the University Healthsystem Consortium; an alliance of 115 U.S. academic medical centers and 300 of their affiliated hospitals). We focused on adults with ID (ages 18+) and examined the common reasons for hospitalization, need for intensive care, as well as common hospitalization outcome measures of length of stay and complications. Analysis was based on a total of 39,397 persons with ID and 7,847,560 persons without ID in the UHC dataset from July 1, 2011 – June 30, 2013. We examined the Medicare Severity Diagnosis Related Groups (MS-DRG), which provides a patient’s principle diagnosis on the date of their discharge.

What did you find out?
The most frequent MS-DRG for adult individuals with ID was psychoses (16.9% of total discharge MS-DRGs of all adult individuals with ID), followed by seizure disorders (7.9% of total), septicemia (5.4% of total), respiratory infections (3.1% of total), pneumonia (2.8% of total), kidney and urinary tract infections (2.4% of total), gastrointestinal (GI) disorders (2.3% of total), nutritional and metabolic disorders (1.9% of total), renal failure (1.6% of total), and GI obstructions (1.6% of total). Together the five most common discharge base MS-DRGs accounted for 36% of hospitalizations of adult individuals with ID. A statistically higher percentage of individuals with ID had intensive care unit stays compared with adults without ID for three of the five base discharge MS-DRGs and a statistically higher percentage had one or more complications for three of the five base MS-DRGS.

What are the take-home messages?
Information about common reasons for hospitalization for individuals with ID may assist in identifying issues to be addressed by improved liaison systems, as well as health issues in need of standards of care and protocols. Attention to improving hospital care may include the need to improve communication and information sharing systems, as well as staff knowledge and attitudes. Education about specific acute care needs of individuals with ID may provide examples for health care professionals about the overall acute care needs of individuals with ID. The findings of this study also have implications for primary care as efforts are needed to improve management of health conditions and prevent hospitalizations for conditions that could be managed in primary care.

To learn more about these findings contact Sarah Ailey.

Full Journal Article
Ailey, S.H., Johnson, T., Fogg, L., & Friese, T.R. (2014). Hospitalizations of adults with intellectual disability in academic medical centers. Intellectual and Developmental Disabilities, 52(3), 187-192.