Comparison of Emergency Admissions for ACSCs Between Adults With and Without ID
| Characteristic | Adults With ID | Adults Without IDa | Unadjusted Modelb | Adjusted Modelc | ||||
|---|---|---|---|---|---|---|---|---|
| Adults, No. | Admissions, No. | Admission Rated | Admission Rated | IRR (95% CI) | P Valuec | IRR (95% CI) | P Valuec | |
| All adults | 16,666 | 3,038 | 61.3 | 11.7 | 5.62 (5.14–6.13) | – | 3.60 (3.25–3.99) | – |
| Stratified by matching factor | ||||||||
| Sex | ||||||||
| Female | 6,989 | 1,428 | 68.5 | 13.1 | 5.68 (5.03–6.42) | – | 3.35 (2.87–3.91) | – |
| Male | 9,677 | 1,610 | 56.1 | 10.7 | 5.56 (4.91–6.30) | .81 | 3.89 (3.39–4.46) | .16 |
| Age-group at baseline, y | ||||||||
| 18–34 | 6,981 | 805 | 42.5 | 6.2 | 7.12 (5.96–8.51) | – | 3.06 (2.47–3.79) | – |
| 35–54 | 6,283 | 1,041 | 51.8 | 8.6 | 6.34 (5.43–7.39) | .34 | 3.25 (2.74–3.87) | .67 |
| 55–84 | 3,402 | 1,192 | 113.5 | 26.2 | 4.56 (4.00–5.20) | <.001 | 4.09 (3.52–4.76) | .03 |
| Stratified by characteristic of adults with ID | ||||||||
| Down syndrome | ||||||||
| Yes | 1,793 | 392 | 73.1 | 9.3 | 10.00 (7.54–13.28) | – | 8.28 (5.73–11.98) | – |
| No | 14,873 | 2,646 | 59.9 | 12.0 | 5.26 (4.79–5.77) | .001 | 3.21 (2.88–3.58) | .002 |
| Communal accommodation | ||||||||
| Yes | 3,392 | 915 | 87.9 | 14.0 | 6.86 (5.78–8.14) | – | 4.98 (4.01–6.20) | – |
| No | 13,274 | 2,123 | 54.2 | 11.1 | 5.20 (4.70–5.76) | .01 | 3.35 (2.98–3.77) | .006 |
| High level of support needsf | ||||||||
| Yes | 3,263 | 1,154 | 113.2 | 12.1 | 10.31 (8.81–12.07) | – | 11.78 (9.78–14.19) | – |
| No | 13,403 | 1,884 | 47.9 | 11.6 | 4.40 (3.95–4.90) | <.001 | 4.28 (3.80–4.81) | <.001 |
ACSC = ambulatory care–sensitive condition; ID = intellectual disability; IRR = incidence rate ratio.
↵a Matched on age, sex, and practice.
↵b IRR from conditional Poisson model for patients with vs without ID. Matched on age, sex, and practice only.
↵c Additionally adjusted for comorbidities (atrial fibrillation, cancer, chronic obstructive pulmonary disease, dementia, diabetes, epilepsy, heart failure, severe mental illness, stroke), Index of Multiple Deprivation quintile, and smoking—for all subgroups except for the subgroup with high support needs, among whom epilepsy was not used in the adjustment.
↵d Admissions per 1,000 adults per year.
e P values test for difference in IRR between subgroups (for age, 18–34 years is the comparator group).
↵f Had been classified as having severe or profound ID by general practitioner or had 2 or more of the following: epilepsy, cerebral palsy or considerable mobility problem (wheelchair use or greater impairment), severe visual impairment, severe hearing impairment, a continence problem, or use of percutaneous endoscopic gastrostomy feeding.