Recording of intellectual disability in general hospitals in England 2006–2019: Cohort study using linked datasets

Accurate recognition and recording of intellectual disability in those who are admitted to general hospitals is necessary for making reasonable adjustments, ensuring equitable access, and monitoring quality of care. In this study, we determined the rate of recording of intellectual disability in tho...

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Published in:PLoS medicine Vol. 20; no. 3; p. e1004117
Main Authors: Sheehan, Rory, Mansour, Hassan, Broadbent, Matthew, Hassiotis, Angela, Mueller, Christoph, Stewart, Robert, Strydom, Andre, Sommerlad, Andrew
Format: Journal Article
Language:English
Published: United States Public Library of Science 20.03.2023
Public Library of Science (PLoS)
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ISSN:1549-1676, 1549-1277, 1549-1676
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Summary:Accurate recognition and recording of intellectual disability in those who are admitted to general hospitals is necessary for making reasonable adjustments, ensuring equitable access, and monitoring quality of care. In this study, we determined the rate of recording of intellectual disability in those with the condition who were admitted to hospital and factors associated with the condition being unrecorded. Retrospective cohort study using 2 linked datasets of routinely collected clinical data in England. We identified adults with diagnosed intellectual disability in a large secondary mental healthcare database and used general hospital records to investigate recording of intellectual disability when people were admitted to general hospitals between 2006 and 2019. Trends over time and factors associated with intellectual disability being unrecorded were investigated. We obtained data on 2,477 adults with intellectual disability who were admitted to a general hospital in England at least once during the study period (total number of admissions = 27,314; median number of admissions = 5). People with intellectual disability were accurately recorded as having the condition during 2.9% (95% CI 2.7% to 3.1%) of their admissions. Broadening the criteria to include a nonspecific code of learning difficulty increased recording to 27.7% (95% CI 27.2% to 28.3%) of all admissions. In analyses adjusted for age, sex, ethnicity, and socioeconomic deprivation, having a mild intellectual disability and being married were associated with increased odds of the intellectual disability being unrecorded in hospital records. We had no measure of quality of hospital care received and could not relate this to the presence or absence of a record of intellectual disability in the patient record. Recognition and recording of intellectual disability in adults admitted to English general hospitals needs to be improved. Staff awareness training, screening at the point of admission, and data sharing between health and social care services could improve care for people with intellectual disability.
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I have read the journal’s policy and the authors of this manuscript have the following competing interests: RSt declares research support received in the last 36 months from Janssen, GSK, and Takeda, and royalties received from Oxford University Press.
ISSN:1549-1676
1549-1277
1549-1676
DOI:10.1371/journal.pmed.1004117