Current services and outcomes of formerly institutionalised and never-institutionalised US adults with intellectual and developmental disabilities: A propensity score matching analysis

J Appl Res Intellect Disabil. 2023 Jul;36(4):859-870. doi: 10.1111/jar.13103. Epub 2023 Apr 13.

Abstract

Background: Deinstitutionalization research shows better services and outcomes relative to institutional life but has not compared formerly institutionalised and never-institutionalised service users.

Methods: We used propensity score matching (PSM) to match formerly institutionalised and never-institutionalised participants on six personal characteristics. Data came from the 2018 to 2019 National Core Indicators In-Person Survey. We excluded current institution residents, and states with 25% + of missing data on former institutionalisation.

Results: Overall, 15.5% of participants in the 29-state full sample had lived in an institution for 1 year or more. Findings from the PSM sample showed that former-institution residents were more likely to use congregate living arrangements and less likely to live with family. They experienced more loneliness, less support-related choice, and had a consistent pattern of disability service-focused social connections.

Conclusions: Many former institution residents remain disadvantaged relative to matched peers. There is a need to identify factors to enhance services and outcomes following deinstitutionalization.

Keywords: community living; deinstitutionalization; formerly institutionalized; intellectual disability; never institutionalized; propensity score matching.

MeSH terms

  • Adult
  • Aged
  • Community Integration*
  • Community Support*
  • Deinstitutionalization* / statistics & numerical data
  • Developmental Disabilities* / psychology
  • Employment, Supported
  • Female
  • Friends
  • Home Environment
  • Humans
  • Intellectual Disability* / psychology
  • Loneliness
  • Male
  • Middle Aged
  • Propensity Score*
  • Religion
  • United States / epidemiology