Indiana University-Purdue University Indianapolis (IUPUI) / Introduction: The prevalence of those aged 3-25 with an intellectual and
developmental disability (I/DD), has increased 17.1% from 1997 to 2008. This study
focused on these I/DD: autism spectrum disorder (ASD), cerebral palsy, learning
disabilities and spina bifida. Previous studies have found that individuals with an I/DD
use health services and the emergency department (ED) more frequently, regardless of
payer.
Methods: This dissertation will describe and define the characteristics of ED use
among children and young adults with an I/DD. A repeated, cross-section of annual data
of a national sample distributed by the Agency for Healthcare Research and Quality
Healthcare Utilization Project National Emergency Department Sample will be analyzed
from 2009-2014. This approach will document the primary clinical reason for ED use,
the appropriateness of the need for a visit, and demographic, geographic, and temporal
correlates for medical, injury, and psychiatric care visits in the ED. The appropriateness
of need will be assessed by the New York University (NYU) Emergency Department
Diagnosis Classification method for medical care visits. A logistic regression model will
be specified for each visit type.
Results: The sample included 386,632 visits with an I/DD diagnosis. The NYU
classification method found that 44.6% of all visits for ASD were classified as nonemergent
yet the other three I/DD had a non-emergent visit rate ranging 25.9%-28.8%. The ASD sub-sample was 51.8% of all visits for psychiatric care and 50.5% of all visits
for injury care. All independent variables tested: admission on weekend, ED trauma
level, age, sex, payer source, patient zip code income quarterlies, and patient rurality,
were found to be statistically different for each model.
Conclusion: The findings indicate the need for development of interventions that
are specific to reducing non-emergent ED utilization for children and young adults with a
diagnosis of ASD and interventions developed for reduction of emergent ED care for the
other I/DD’s. In addition, unique interventions are needed to reduce the utilization of the
ED for psychiatric care specifically for the ASD population and utilization of the ED for
injury care for all I/DD diagnoses. / 2021-05-08
| Identifer | oai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/19247 |
| Date | 04 1900 |
| Creators | Mullen, Cody J. |
| Contributors | Stone, Cynthia, Menachemi, Nir, Monahan, Patrick, Johnston, Ann |
| Source Sets | Indiana University-Purdue University Indianapolis |
| Language | en_US |
| Detected Language | English |
| Type | Dissertation |
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