A Consultation Model for Intellectual and Developmental Disability Care.

Abstract

Purpose: To provide an overview of an innovative, consultative care model for patients with Intellectual and Developmental Disabilities (IDD) within a Family Medicine department.

Methods: We conducted a retrospective chart review of all patients seen in the clinic between 2017 to 2023 to identify patient demographics (eg, age), clinical needs (eg, diagnoses and referral needs), and administrative characteristics (eg, Medicaid status). We also conducted a spatial analysis to evaluate each patient's estimated travel distance and time to the clinic.

Results: The number of patients seen in the IDD clinic totaled 184, with 65% male patients (n = 120) and a mean age of 31.29 years (SD = 16.27). More than half of patients, 65%, were insured by Medicaid (n = 119), and almost half received services paid for by the state Medicaid waiver (43%, n = 80). Many patients lived with family (64%, n = 117) and reported family guardianship (55%, n = 101). The spatial analysis identified that the majority of patients, 86% (n = 159) were nonrural residents based on Rural-Urban Continuum Codes. The mean distance traveled was 20.41 (SD = 21.36) miles with a mean travel time of 27.08 minutes (SD = 21.78). Following the consultations, 38% received outgoing referrals. Referral locations included psychiatry (8%), neurology (3%), behavioral health counseling (3%), and other medical services (17%).

Conclusion: This study demonstrates the diverse characteristics of patients with IDD receiving care through a consultative-based model of care. This model appeared to provide services for patients from a wide geographic catchment area that may not have otherwise had health care access.