Comparative mortality of people with mental retardation in institutions and the community.
The role of institutions has come into question in recent decades, and the size of the institutionalized population has been drastically reduced. Risk-adjusted mortality rates in institutions and the community in California from 1980 through 1992 were compared, with the aim of improving our understanding of the capacity of the community health system to support deinstitutionalization. Risk-adjusted odds on mortality were estimated to be 72% higher in the community than in institutions. Some problems with health care delivery in the community were reviewed; these may help account for the difference. Consumers and guardians should weight these considerations when making choices between institutional versus community-based care.
Strauss
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Department of Statistics, University of California, Riverside 92521, USA.
Kastner
T A
TA
D000203:Activities of Daily Living; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D016001:Confidence Intervals; D016208:Databases, Factual; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D016352:Group Homes / Q000706:statistics & numerical data; D006701:Home Nursing / Q000706:statistics & numerical data; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data*; D008607:Intellectual Disability / Q000401:mortality* / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012306:Risk; D012494:Sampling Studies; D012720:Severity of Illness Index