Article Figures & Data
Tables
Indicator Developmental Disability % (95% CI) No Developmental Disability % (95% CI) Prevalence Ratio % (95% CI)a Health status: fair or poor 0–18 yb 27.7 (22.7–32.6) 1.1 (0.8–1.4) 25.3 (18.5–34.6)c 19–30 yd 42.8 (33.0–52.6) 6.7 (5.9–7.6) 6.3 (4.9–8.2)c 31–64 ye 71.0 (66.6–75.3) 11.3 (10.7–11.8) 6.3 (5.8–6.8)c ≥65 yf 76.0 (67.4–84.6) 4.3 (3.8–4.9) 4.3 (3.8–4.9)c Utilizationg ≥2 Overnight hospitalizations 0–18 y 8.5 (5.5–11.4) 0.7 (0.5–.0.9) 12.3 (7.7–19.6)c 19–30 y 14.2 (7.0–21.5) 2.3 (1.8–2.8) 6.1 (3.5–10.7)c 31–64 y 13.8 (10.8–16.8) 2.2 (2.0–2.5) 6.2 (4.8–7.9)c ≥65 y 17.5 (10.2–24.8) 4.6 (4.0–5.1) 3.8 (2.5–5.9)c ≥2 Emergency department visits 0–18 y 23.8 (19.1–28.6) 7.0 (6.3–7.7) 3.4 (2.7–4.3)c 19–30 y 37.0 (27.4–46.6) 11.6 (10.5–12.7) 3.2 (2.4–4.2)c 31–64 y 36.8 (32.2–41.4) 6.3 (5.9–6.8) 5.8 (5.0–6.7)c ≥65 y 34.5 (24.1–44.9) 5.7 (5.0–6.3) 6.1 (4.4–8.4)c Qualityg Primary care physician usually or always spends enough time with patient 0–18 y 91.6 (88.0–95.1) 90.8 (89.9–91.8) 1.01 (0.97–1.05) 19–30 y 70.0 (54.5–85.5) 82.6 (80.5–84.7) 0.85 (0.68–1.06) 31–64 y 83.2 (78.9–87.5) 90.8 (90.2–91.5) 0.92 (0.87–0.96) ≥65 y 75.5 (63.9–87.0) 92.7 (91.9–93.5) 0.81 (0.70–0.95)c Primary care physician usually or always explains things well 0–18 y 94.7 (91.4–98.0) 96.4 (95.8–96.9) 0.98 (0.95–1.02) 19–30 y 89.7 (80.7–98.6) 94.5 (93.2–95.7) 0.95 (0.86–1.05) 31–64 y 84.5 (80.0–89.0) 96.0 (95.5–96.4) 0.88 (0.84–0.93)c ≥65 y 83.0 (73.2–92.9) 95.0 (94.4–95.7) 0.87 (0.78–0.98)c Accessg Usual source of care 0–18 y 98.8 (97.5–100.0) 95.5 (95.0–96.0) 1.03 (1.02–1.05)h 19–30 y 88.5 (83.0–93.9) 83.2 (82.0–84.4) 1.06 (1.00–1.13) 31–64 y 93.0 (90.2–95.9) 91.4 (90.9–91.9) 1.02 (0.99–1.05) ≥65 y 96.7 (93.2–100.0) 96.1 (95.6–96.6) 1.01 (0.97–1.04) Delayed treatment 0–18 y 10.1 (6.8–13.4) 2.4 (2.0–2.8) 4.2 (2.9–6.0)c 19–30 y 23.2 (15.1–31.3) 14.3 (13.1–15.5) 1.6 (1.1–2.3)h 31–64 y 32.5 (27.9–37.1) 15.6 (15.0–16.3) 2.1 (1.8–2.4)c ≥65 y 14.9 (7.6–22.2) 6.9 (6.2–7.6) 2.2 (1.3–3.6)h Problem getting needed care 0–18 y 13.7 (10.1–17.4) 2.1 (1.7–2.5) 6.4 (4.7–8.9)c 19–30 y 16.2 (9.0–23.4) 5.4 (4.6–6.2) 3.0 (1.9–4.8)c 31–64 y 23.1 (19.1–27.1) 4.9 (4.5–5.3) 4.7 (3.9–5.8)c ≥65 y 17.5 (8.5–26.5) 2.4 (2.0–2.8) 7.3 (4.2–12.6)c Received same-day care urgent needs 0–18 y 47.5 (41.3–53.7) 61.1 (59.6–62.7) 0.78 (0.68–0.89)c 19–30 y 34.7 (14.5–55.0) 38.6 (34.2–43.0) 0.90 (0.50–1.63) 31–64 y 28.9 (22.3–35.4) 42.8 (40.9–44.6) 0.68 (0.54–0.85)h ≥65 y 12.5 (1.1–24.0) 42.2 (39.5–44.9) 0.30 (0.12–0.74)h Waited 2 or more days for urgent needs 0–18 y 29.9 (24.3–35.5) 16.1 (14.9–17.3) 1.9 (1.5–2.3)c 19–30 y 38.2 (17.7–58.6) 34.3 (30.0–38.6) 1.1 (0.64–1.9) 31–64 y 48.0 (40.8–55.3) 30.2 (28.5–31.9) 1.6 (1.4–1.9)c ≥65 y 44.0 (24.6–63.4) 29.0 (26.4–31.5) 1.5 (0.97–2.4) Usually or always received needed after-hours care from primary care physician 0–18 y 59.4 (53.0–65.7) 61.6 (60.0–63.2) 0.96 (0.86–1.08) 19–30 y 53.8 (24.0–83.6) 59.6 (53.7–65.5) 0.90 (0.51–1.59) 31–64 y 44.9 (35.6–54.2) 48.5 (45.6–51.4) 0.92 (0.75–1.15) ≥65 y 46.8 (23.9–69.8) 56.5 (51.8–61.2) 0.83 (0.50–1.36) Problem seeing a specialisti 0–18 y 24.6 (19.2–30.0) 19.3 (17.0–21.6) 1.3 (0.99–1.6) 19–30 y 52.3 (38.6–66.1) 26.8 (23.7–30.0) 2.0 (1.5–2.6)c 31–64 y 47.6 (41.8–53.4) 19.7 (18.4–21.0) 2.4 (2.1–2.8)c ≥65 y 45.8 (32.5–59.1) 12.9 (11.5–14.2) 3.6 (2.6–4.9)c Unmet health care needg Dental 0–18 y 8.3 (5.1–11.4) 3.3 (2.8–3.8) 2.5 (1.7–3.8)c 19–30 y 34.2 (24.7–43.8) 14.0 (12.8–15.2) 2.4 (1.8–3.3)c 31–64 y 34.4 (29.9–38.9) 10.0 (9.5–10.6) 3.4 (3.0–3.9)c ≥65 y 20.8 (12.2–29.3) 5.0 (4.5–5.6) 4.1 (2.7–6.3)c Vision 0–18 y 5.0 (2.6–7.3) 1.8 (1.4–2.2) 2.8 (1.7–4.6)c 19–30 y 28.7 (19.4–38.0) 8.0 (7.0–8.9) 3.6 (2.6–5.1)c 31–64 y 31.3 (26.9–35.7) 9.5 (9.0–10.0) 3.3 (2.8–3.8)c ≥65 y 24.4 (14.9–34.0) 5.5 (4.9–6.1) 4.4 (2.9–6.6)c Prescription 0–18 y 9.7 (6.4–13.0) 1.7 (1.4–2.0) 5.7 (3.9–8.4)c 19–30 y 24.8 (16.2–33.4) 12.4 (11.2–13.5) 2.0 (1.4–2.9)h 31–64 y 28.3 (24.1–32.5) 14.2 (13.5–14.8) 2.0 (1.7–2.3)c ≥65 y 24.6 (15.1–34.0) 9.3 (8.5–10.1) 2.6 (1.8–3.9)c Other (eg, medical examination, medical supply) 0–18 y 10.6 (7.3–13.9) 1.7 (1.4–2.0) 6.3 (4.4–9.1)c 19–30 y 27.5 (18.6–36.3) 6.3 (5.5–7.2) 4.3 (3.1–6.2)c 31–64 y 26.2 (22.0–30.5) 6.1 (5.6–6.5) 4.3 (3.6–5.2)c ≥65 y 10.5 (5.2–15.7) 2.3 (1.8–2.7) 4.6 (2.7–7.9)c ≥1 Unmet need 0–18 y 19.6 (15.2–24.0) 5.7 (5.0–6.3) 3.5 (2.7–4.4)c 19–30 y 55.9 (46.1–65.8) 25.6 (24.1–27.1) 2.2 (1.8–2.6)c 31–64 y 61.2 (56.6–65.8) 25.4 (24.6–26.1) 2.4 (2.2–2.6)c ≥65 y 50.1 (39.7–60.3) 16.8 (15.8–17.8) 3.0 (2.4–3.7)c Note: Because individuals with developmental disabilities represent a small percentage of the population, some outcomes were endorsed by a small number of respondents.
↵a Prevalence ratios and P values are for the difference in health indicators between people with and without developmental disabilities within each age-group.
↵b Developmental disability, n = 419; no developmental disability, n = 7,701.
↵c P <.001.
↵d Developmental disability, n = 148; no developmental disablility, n = 5,225.
↵e Developmental disability, n = 779; no developmental disability, n = 19,369.
↵f Developmental disability, n = 178; no developmental disability, n = 10,044.
↵g During the past 12 months.
↵h P ≤.01.
↵i Among respondents who needed specialist care (19.3% of children with a developmental disability and 78.4% of children with no developmental disability did not need specialist care; 34.7% of adults with a developmental disability aged 19 years and older and 67.1% of adults with no developmental disability aged 19 years and older did not need specialist care).
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The Article in Brief
Health Care Disparities of Ohioans With Developmental Disabilities Across the Lifespan
Susan M. Havercamp , and colleagues
Background Developmental disabilities are severe, chronic conditions that impair cognitive and/or physical functioning, resulting in significant functional limitations throughout the lifespan. This study explores differences in a range of health indicators between people with and without developmental disabilities.
What This Study Found There are significant disparities between individuals with and without developmental disabilities in health status, health care quality, utilization, access to care, and unmet healthcare needs. A telephone survey found that children and older adults with developmental disabilities experienced the greatest disparities in unmet healthcare needs. Fourteen percent of children 0-18 years of age with developmental disabilities reported problems getting needed care, compared to 2 percent of children without developmental disabilities. Among adults age 65 and older, 50 percent of those with developmental disabilities reported one or more unmet health care needs, compared to 17 percent of those without such disabilities.
Implications
- The authors call for medical schools to incorporate training in developmental disabilities into their curricula to help reduce health care disparities.
