Hospital readmissions among people with intellectual disabilities compared to the general population: a longitudinal register study
Disability Studies Conference 2024 - Leeds (UK), September 3-5 2024
Magnus Sandberg, Jimmie Kristensson, Emilie Stroh, Anna Axmon
[View presentation] [Project main site]
Background: People with Intellectual disabilities (ID) have more healthcare utilization, especially unplanned inpatient care. One reason could be too early hospital discharges, resulting in readmissions. This is an important aspect of quality of care that has not been thoroughly assessed among people with ID.
Aim: To investigate readmission to hospital within 30 days among people with ID compared to the general population.
Method: We included all people living in Skåne, Sweden, January 1st 2014. Those with a diagnosis of ID (F7 in ICD-10) or Down Syndrome (Q90), or with service and support for people with ID or autism spectrum disorder, comprised the ID cohort (n=14,716). Family/household members of people in the ID cohort were excluded. The remaining comprised the general population cohort (gPop; n=1,232,299). Data included inpatient care dates and diagnoses for a pre-pandemic (2014-2019) and a pandemic (2020-2021) period. This resulted in 1,228,325 inpatient registrations for the gPop cohort and 26,091 for the ID cohort.
Results: People in the ID cohort had increased risk for having at least one readmission for the same diagnosis both before (RR 2.2, 95% CI 2.1-2.4) and during the pandemic (RR 2.8, 95% CI 2.5-3.2). The same pattern was seen for number of readmissions (RR 4.0 95% CI 3.8-4.2; RR 4.3 95% CI 4.0-4.7). The median number of days until readmission for the same diagnosis was 7 in the ID cohort (interquartile range 3-15) and 10 in the gPop (4-18).
Conclusion: People with ID seem to have higher risks for readmission and are also readmitted sooner than the general population. This is likely not due to multimorbidity, as that would result in longer hospital stays rather than a readmission. The timing of discharge of people with ID needs to be planned more carefully.
Research group
Associate professor Magnus Sandberg (PI for IDcare)
Associate professor Anna Axmon (PI for the covid follow-up study)
Professor Ulf Gerdtham
Associate professor Jimmie Kristensson
Collaborations
Ass prof Julia Bahner, Lund University, Sweden
Dr Trine Lise Bakken, Oslo University Hospital, Norway [prevalence of schizophrenia]
Dr Petra Björne, City of Malmö, Sweden
Prof Darren Chadwick, Liverpool John Moores University, UK
Prof David Edvardsson, La Trobe University, Melbourne, Australia [dementia]
Prof Kristina Edvardsson, La Trobe University, Melbourne, Australia [pregnancy outcomes]
Dr Karin Engström, Lund University, Sweden
Dr Hanna Falk Erhag, University of Gothenburg, Sweden
Dr Alessandra Grotta, Stockholm University, Sweden
Ass prof Björn Hofvander, Lund University, Sweden
Prof Silke Kern, University of Gothenburg, Sweden
Dr Katarina Lauruschkus, Lund University, Sweden
Dr Can Liu, Stockholm University and Karolinska Institutet, Sweden
Prof Yona Lunsky, University of Toronto, Canada
Ass prof Hugo Lövheim, Umeå University, Sweden [dementia]
Dr Emilie Stroh, Lund University, Sweden [care transitioning] [diabetes]