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Continuity of Care to Prevent Emergency Room Use Among Persons With Intellectual and Developmental Disabilities
Author(s) -
Wood David,
Hall Allyson,
Hou Tao,
Wludyka Peter,
Zhang Jianyi
Publication year - 2007
Publication title -
journal of policy and practice in intellectual disabilities
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.592
H-Index - 30
eISSN - 1741-1130
pISSN - 1741-1122
DOI - 10.1111/j.1741-1130.2007.00127.x
Subject(s) - specialty , medicaid , emergency department , continuity of care , medicine , primary care , ethnic group , family medicine , gerontology , health care , medical emergency , nursing , sociology , anthropology , economics , economic growth
The study explored the relationship between the level of primary and specialty care continuity and the likelihood of subsequent emergency room use for persons with intellectual and/or developmental disabilities (I/DD). Administrative files from the state's Agency for Persons with Disabilities from 1999 to 2003, containing demographic and clinical information, were used to identify persons with I/DD living in Florida and then were merged with the Florida Medicaid Claims database for outpatient and emergency room services from 1999 to 2003. For individuals with at least two primary or specialty care visits in 2000 and 2001, the Modified, Modified Continuity Index (M,MCI) was calculated and the M,MCI scores were used in multivariable models to predict emergency room utilization in 2002. Primary and specialty care continuity varied by sex, ethnicity, age, and IQ. Multivariate analyses controlling for socio‐demographic and clinical characteristics showed that high continuity for both primary and specialty care was associated with a 28% reduction in the likelihood of an emergency room visit. Continuity in both primary and specialty care is important for adults with I/DD in order to adequately manage their complex health problems and prevent health problems from deteriorating to the point of needing emergency care.