Healthcare utilisation and unmet health needs in children with intellectual disability: a propensity score matching approach using longitudinal cohort data.
E Nicholson, E Doherty, S Guerin and 3 others
PMID 35285998WHAT IT FOUND
Children with intellectual disability had similar GP and emergency department use to peers, but were more likely to be seen in hospital and stay overnight at age 9.
Caregivers reported unmet health needs at ages 9 and 13, primarily due to waiting lists and lack of accessible care.
Key findings
01At age 9, children with ID were more likely to have had an overnight hospital stay and contact with a medical doctor in a hospital, but there was no significant difference in GP or emergency department attendance.
02These differences in hospital use were not maintained at age 13.
03Caregivers of children with ID were more likely to report unmet healthcare needs at both age 9 and age 13, with common reasons including lack of accessible care and waiting lists.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied on self-reported healthcare use from caregivers, which is subject to recall bias. Clinical reasons for healthcare visits and severity of illness were not available, so it is unclear if hospitalisations were avoidable. The sample size for children with ID was small (124), preventing analysis by severity of disability. The ID group had a higher prevalence of chronic illness and behavioural/mental health conditions, which may influence care patterns beyond ID alone.
Declared interests
The work was supported by the Health Research Board (HRB) under an Applying Research into Policy and Practice Fellowship. The funder had no role in the research. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that children with ID have higher rates of emergency department or GP visits. After matching for confounders like socio-economic status and health, there was no significant difference in these primary care settings. The disparity was specifically in hospital-based care and unmet needs.