Hospital admissions up to eight times higher for people with intellectual disability, Australian study finds

Potentially avoidable hospitalisations occur at a rate up to eight times higher for people with intellectual disability than the general population, according to new research.

Advocates say the findings point to an urgent need for improved preventative healthcare in people with intellectual disability.

The report, published in the Medical Journal of Australia, analysed New South Wales hospitalisations between 2001 and 2015 that could have been prevented by adequate treatment, either by general practitioners or other health professionals in the community.

These included acute conditions such as pneumonia and urinary tract infections, as well as chronic conditions like asthma and high blood pressure.

Linking the statistics with data on 92,542 people with an intellectual disability in NSW, the research found a significant difference in the rates of hospital admissions for acute conditions, which were between five and eight times higher in those with intellectual disability.

Hospital stays for vaccine-preventable conditions, such as the seasonal flu, were three times higher.

Prof Julian Trollor, the chair of intellectual disability mental health at the University of NSW and the study’s lead researcher, said the discrepancy in vaccine-preventable admissions was particularly concerning as rates of those hospitalisations in people with intellectual disability appeared to be increasing.

“We know that a lack of vaccination for some of those conditions can actually be a factor in the death of a person,” Troller said.

The disability royal commission last year found “formidable barriers to quality health care” for people with intellectual disability in Australia, “often with serious and sometimes tragic consequences”.

“We’re seeing huge gaps for this population, which essentially suggests that the health inequality is so great that it eclipses that of Aboriginal Australians,” Trollor said.

Admission rates were six times higher for dental conditions and three times higher for chronic lung conditions, excluding asthma, in people with intellectual disability.

Potentially preventable admissions for convulsions and epilepsy were 22 times higher, but Trollor said the difference could be partly attributable to the high rate of seizure conditions in people with intellectual disability.

“These are common conditions and so they’re presenting more often, but they may also not be managed as effectively or optimally as possible in the community,” Trollor said.

Jim Simpson, a senior advocate at the Council for Intellectual Disability, said the research confirmed years of anecdotal reports from people with intellectual disability and their families.

“All too often, health conditions are not prevented or diagnosed early, which means that people end up in hospital with acute conditions that could have been avoided,” Simpson said. “Urgent and robust action is needed.”

Prof Christine Bigby, a disability researcher at La Trobe University who was not involved in the research, said better diagnostic skills and specialised training were required of health workers to adequately treat people with intellectual disability.

“If you live in a group home, for instance, you’ll have staff that work on shifts,” she said. “There may not be good tracking of behaviour that indicates there’s problems.”

Jack Kelly, a 25-year-old man in Sydney who has cerebral palsy, quadriplegia and an intellectual disability, was hospitalised in March this year. Kelly told Guardian Australia he was admitted overnight for suspected aspiration of fluid into his lungs, a condition normally managed by his regular GP.

Kelly lives in an assisted living facility, but a registered nurse was not on shift to make a health assessment at the time. He was sent to hospital out of caution. “It ended up being unnecessary because there wasn’t anything on my lungs,” Kelly said.

“I’ve definitely had situations in the past where support workers haven’t necessarily taken it seriously and it escalated my health issues,” he said.

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