Electronic Health Record Analysis of the Primary Care of Adults With Intellectual and Other Developmental Disabilities

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Abstract
Adults with intellectual and other developmental disabilities (IDD) are at risk for suboptimal primary healthcare. Electronic Health Record (EHR) analyses are an underutilized resource for studying the health and primary care of this population. Authors report on a case‐control EHR analysis of adults with IDD provided primary care through a Cleveland, Ohio, USA, area clinic between 2005 and 2008. The IDD cohort was identified by relevant International Classification of Disease, Ninth Revision codes in problem list and encounter diagnoses. A comparison cohort matched by age, sex, race, and insurance was also specified. Demographic, health, and health service characteristics of the two cohorts were compared. The IDD cohort consisted of 1,267 individuals (mean age: 39 years; 54% male). Age, sex, racial, and health insurance characteristics were similar in the 2,534 individuals in the comparison cohort. Individuals with IDD were significantly more likely to carry comorbid diagnoses of epilepsy, constipation, osteoporosis, obesity, and hyperlipidemia, but were significantly less likely to bear comorbid diagnoses of hypertension, diabetes, osteoarthritis, heart failure, coronary heart disease, and chronic obstructive pulmonary disease. Despite a lower mean body mass index, individuals with IDD were more likely to be labeled obese. Only genetic consultation rates were higher in the IDD cohort. Health services research related to persons with IDD is becoming more feasible as large health systems adopt EHRs. Further analyses should investigate whether variations in disease rates in adults with IDD represent true differences in disease prevalences vs. disparities in healthcare.

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