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Health Status & Care Utilization of Adults with Developmental Disabilities Living in Group Homes in Ontario

Applied Health Research Question submitted to H-CARDD by the Ontario Ministry of Community and Social Services
Authors: Yona Lunsky, Julie Klein-Geltink, Robert Balogh, Elizabeth Lin & Andrew Wilton

Background

Over the last several decades, there has been a shift from institutionalization to community services and supports. Studies in the United Kingdom and the United States suggest that the disease profile and health care of adults with developmental disabilities may differ according to residential setting.

Purpose

The purpose of this report was to examine the health status and health care of adults with developmental disabilities who live in Ontario Ministry of Community and Social Services-funded residential settings.

Methods

A cohort of adults with developmental disabilities aged 18 to 64 years was created using Ontario health and social services administrative data from the Institute for Clinical Evaluative Sciences and the Ontario Ministry of Community and Social Services. There were 7,322 adults with developmental disabilities living in group homes. They were compared to individuals with developmental disabilities overall and a random 20% sample of adults without developmental disabilities.

Results

  • Compared to adults with developmental disabilities overall and adults without developmental disabilities, adults with developmental disabilities living in group homes were somewhat older. Their income distribution was more similar to adults without developmental disabilities than adults with developmental disabilities overall, who tended to be poorer.
  • There was geographic variation in the percent of people with developmental disabilities living in group homes; the largest proportions were in the Hamilton Niagara Haldimand Brant, Central, and Champlain Local Health Integration Networks.
  • Adults with developmental disabilities living in group homes had similar rates of mental health problems compared to adults with developmental disabilities, but their rates of other chronic conditions (i.e., chronic obstructive pulmonary disease, asthma) were lower. Like adults with developmental disabilities overall, they were more likely than individuals without developmental disabilities to have moderate, high, or very high levels of morbidity.
  • They were more likely to use primary care, speciality care, and emergency care compared to adults with developmental disabilities overall and adults without developmental disabilities but their average number of visits was lower than that of adults with developmental disabilities overall.
  • They were more likely to have a periodic health examination but had higher rates of preventable hospitalizations and similar cancer screening rates compared to adults with developmental disabilities overall.

Conclusions and Implications

Adults with developmental disabilities living in group homes have a unique health profile. These findings can be used to inform future residential staff training, policy making, and identification of under-performing areas.