Primary care for people with intellectual and development disabilities (IDD) and diabetes or hypertension; highlighting current gaps in care.

Abstract

Background: People with intellectual and developmental disabilities (IDD) are at higher risk for chronic conditions (diabetes and hypertension) but may experience barriers to chronic disease management when primary care services are not tailored to their unique needs.

Objective: This quantitative study examines patterns of primary care service use, chronic disease management, and colorectal cancer screening among people with IDD and chronic disease and explores potential disparities in care.

Methods: We use population-based linked administrative data from British Columbia to identify people with diabetes and/or hypertension and compare patterns of health service utilization and evidence-informed chronic disease management stratified by recorded IDD diagnosis.

Results: Among people with diabetes and/or hypertension, people with IDD access outpatient primary care visits (nurse practitioners and general practitioners) at rates slightly higher than people without IDD (11.4 vs 9.2 visits per year), receive emergency department care three times as often (2.1 vs 0.6 visits per year), and are hospitalized four times as often (40 vs 10 hospitalizations per 100 people per year). Despite more frequent health care contact overall, individuals with IDD were less likely to receive recommended lab tests for chronic disease management and colon cancer screening (60.7% among people with IDD vs 75.9%).

Conclusions: Disparities in chronic disease management and cancer screening, despite more frequent health system contact overall may explain poorer health outcomes for people with IDD and reflect persistent systemic and societal barriers. Addressing current barriers is critical to developing more equitable health systems.