Hospital readmissions nearly two times more likely for people with intellectual and developmental disabilities and mental illness than those with mental illness alone

The 30-day all-cause hospital readmission rate in people with mental illness and intellectual and developmental disabilities (IDD) is 15 per cent, 1.7 times higher than mental illness alone, according to a new study from the Institute for Clinical Evaluative Sciences (ICES).

The rate of all-cause hospital readmissions (meaning that the cause of the readmission does not need to be related to the cause of the initial hospitalization) within 30 days of discharge is an important indicator of health system performance and decreasing the rate is a priority for both Canadian provincial and American state hospitals.

“A potential way to prevent readmission in people with IDD and mental illness is to flag members of this group during admission in order to target their unique health and social care needs,” says Robert Balogh, lead author of the study, adjunct scientist at ICES and assistant professor in the Faculty of Health Sciences at the University of Ontario Institute of Technology.

The study published today in Psychiatric Services is the first to look at readmission rates in individuals with IDD and a comorbid mental illness. The researchers examined the data of 66,484 adults with IDD from Ontario and created two groups: individuals with IDD only and those with IDD and mental illness and compared them to individuals with mental illness only.

“It is too late at the time of discharge to consider what is most appropriate for someone with IDD. We have to look at these patients in a unique way right from the day they are admitted in order to plan for an appropriate and well supported transition back to the community. We know they are at greater risk of returning, so we have to do more to set up successful discharges. Otherwise, it is that much more traumatic and costly to bring them back,” says Yona Lunsky, director of the Healthcare Access Research and Developmental Disabilities (H-CARDD) research program, co-author of the study and adjunct scientist at ICES.

The researchers add that appropriate community-based housing options with access to specialized clinical supports are needed to facilitate successful hospital discharges to the community.

This study is part of the Healthcare Access Research in Developmental Disabilities (H-CARDD) Program.

“All cause, 30-day readmissions among persons with intellectual and developmental disabilities and mental illness,” was published today in Psychiatric Services.

Author block: Balogh RS, Lin E, Dobranowski K, Selick A, Wilton A, Lunsky Y.

The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario

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