Differences in Hospital-Based Care for Patients With Intellectual and Developmental Disabilities

Importance: The number of adults with intellectual and developmental disabilities (IDD) seeking treatment in non-IDD-specific health care settings is growing. Little is known about how adults with IDD use health care services in specialty settings, including occupational therapy services.

Objective: To describe adults with IDD in hospitals and identify differences in utilization patterns compared with patients without IDD.

Design: Descriptive and correlational designs were used.

Participants: Data were obtained from Vizient (Clinical Data Base/Resource Manager™), a national database of administrative discharge abstracts for adults admitted to hospitals for an orthopedic procedure. From this sample, subsamples of (1) patients diagnosed with IDD and (2) an age- and gender-matched sample of patients without IDD were identified.

Results: The study cohort with IDD experienced longer lengths of stay, t(2821.5) = -14.2, p < .001; were more likely to have Medicare coverage, χ2(3, N = 8,472) = 1,170.38, p < .001; and were more commonly discharged to subacute or skilled nursing facilities, χ2(5, N = 8,472) = 1,033.60, p < .001. Differences in occupational therapy services were also noted.

Conclusions and relevance: Despite similarities in orthopedic procedures, participants with IDD had different use patterns than those without IDD. Differences may be attributed to varying client factors and contexts. The results also indicate that practitioners in non-IDD-specific settings should expect to encounter clients with IDD. Occupational therapy practitioners have an opportunity to be leaders in adapting treatment protocols and providing education to caregivers and health care providers on behalf of people with IDD. What This Article Adds: This article provides novel information about a population that is known to experience disparities in health outcomes. It offers a basis on which future research can build to improve health care delivery and occupational therapy interventions to improve outcomes.