Day Service Provision for People with Intellectual Disabilities: A Case Study Mapping 15-Year Trends in Ireland

J Appl Res Intellect Disabil. 2017 Mar;30(2):383-394. doi: 10.1111/jar.12249. Epub 2016 Feb 26.

Abstract

Background: Day services for people with intellectual disabilities are experiencing a global paradigm shift towards innovative person-centred models of care. This study maps changing trends in day service utilization to highlight how policy, emergent patterns and demographic trends influence service delivery.

Methods: National intellectual disability data (1998-2013) were analysed using WINPEPI software and mapped using QGIS Geographic Information System.

Results: Statistically significant changes indicated fewer people availing of day services as a proportion of the general population; more males; fewer people aged <35; a doubling in person-centred plans; and an emerging urban/rural divide. Day services did not change substantially and often did not reflect demand.

Conclusions: Emergent trends can inform future direction of disability services. Government funds should support individualized models, more adaptive to changing trends. National databases need flexibility to respond to policy and user demands. Future research should focus on day service utilization of younger people and the impact of rurality on service availability, utilization, quality and migration.

Keywords: day services; implementation; individ-ualized support; intellectual disability; person-centred plan; personal budget.