Re-examining the relationship between intellectual disability and receipt of inpatient psychiatry and complex continuing care services in Ontario, Canada

Abstract

Objectives:

Over the last few decades, new residential, vocational, recreational, and educational opportunities for persons with intellectual disabilities (ID) in Ontario (Canada) have allowed them to integrate into mainstream society. However, persons with ID continue to struggle to fit into the healthcare system. In particular, previous work reported that persons with ID tended to receive more interventions that focused on behaviour management, and less related to community skills and reintegration. The current study determines whether the presence of an ID diagnosis continues to predict service use.

Methods:

Analyses are based on anonymized population-level data collected as part of regular clinical practice in inpatient psychiatry (171495 assessments, 3·9% have an ID) and complex continuing care (CCC) hospitals (112021 assessments, 1·32% have an ID) in Ontario. Multivariate logistic regression models were used to test the relationship between ID and services, controlling for select confounders.

Results:

The results showed that persons with and without ID in inpatient psychiatry and CCC continue to have differential odds of receiving various healthcare services, in spite of needs recognized through the assessment. Overall, interventions that target behaviours rather than improvement of skills are received by persons with ID in both settings.

Conclusion:

Persons with ID continue to experience inequities in the Ontario healthcare system.

Keywords:

• service utilization
• inpatient psychiatry
• complex continuing care
• inequity

Acknowledgements

This study is part of the National Population Health Study of Neurological Conditions. We wish to acknowledge the membership of Neurological Health Charities Canada and the Public Health Agency of Canada for their contribution to the success of this initiative.

Funding for the study was provided by the Public Health Agency of Canada. The opinions expressed in this publication are those of the authors/researchers, and do not necessarily reflect the official views of the Public Health Agency of Canada.

The author also gratefully acknowledges the assistance of Patty Montague with statistical analysis of the data.