Healthcare Utilisation in Ageing Adults With Intellectual Disability: Longitudinal Evidence From Five Waves of IDS-TILDA.
Martin McMahon, Aviejay Paul, Catriona Ryan and 4 others
PMID 42050748WHAT IT FOUND
Where older adults with intellectual disability live was linked to their health service use more than their health conditions were.
People in group homes or residential settings saw GPs and used outpatient and emergency services more than those living with family or independently.
Key findings
01Living arrangement was one of the strongest predictors of service use: people in community group homes were almost twice as likely to use GP and outpatient services and 1.47 times as likely to use emergency services as people living independently or with family, and those in residential settings used services even more.
02Chronic conditions were linked to outpatient and emergency use but not to GP use. Neurological, joint, gastrointestinal disease and stroke increased emergency use, and people with multimorbidity were 1.64 times more likely to attend an emergency department. Neurological, heart, endocrine, joint, gastrointestinal disease, cancer and multimorbidity all increased outpatient use, while no condition was associated with GP use.
03Neither the level of intellectual disability nor Down syndrome status significantly changed how much people used these services.
STILL TO COME
How it was doneWhat they found
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What it does not show
Chronic conditions were reported by the participant or a proxy, with no medical records or clinical checks, so some conditions may have been missed or misreported. The study recorded only whether someone used a service at all, not how many times, so one visit and many visits look the same in the data. Living arrangements were treated as fixed over the 14 years, though where people live can change. Wave 4 took place during the COVID-19 pandemic, which changed how healthcare was organised; the authors describe this as a period effect. The results pool the five waves together, so they are averages and should not be read as showing that services stayed equally available throughout. The study only covers people already known to health and social care services. People not known to services may have worse health and are not represented here. No sample size calculation was done, because this was a secondary analysis of an existing cohort. New participants were added at waves 4 and 5, which may have introduced differences the analysis did not account for.
Declared interests
Funded by the Health Research Board Ireland (IDS-TILDA-2021-001) and the Department of Children, Disability and Equality. The authors declare no conflicts of interest.
The easy way to misread this
Do not read the higher service use among people in group homes and residential settings as evidence that those settings make people sicker. The study can only show an association, it measured whether someone used a service at all rather than how often, and the authors point out that high use does not necessarily mean good care but may reflect reliance on services or fragmented care.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →