title: Mortality in persons with developmental disabilities after transfer into community care.
abstract: More than 2,000 persons with developmental disabilities have been transferred from California state institutions into community care in recent years. We investigated whether this has been accompanied by a change in mortality rates, using data on 1,878 clients moved since April 1993. Mortality rates were compared to those expected for comparable persons in institutions. Risk-adjusted mortality rates for movers exceeded institutional rates by 51%, p < .05. After removal of cancer deaths in both groups, this increased to 67%. The effect was largest shortly after the move and in the subjects who had moved most recently. The deinstitutionalization process in California appears to have resulted in a substantial increase in mortality, indicating the need to ensure continuous, consistent, and competent medical care and supervision in the community.
authors.affiliation: Department of Statistics, University of California, Riverside 92521, USA. strauss@citrus.ucr.edu
authors.forename: D
authors.initials: D
authors.lastname: Strauss
authors.forename: R
authors.initials: R
authors.lastname: Shavelle
authors.forename: A
authors.initials: A
authors.lastname: Baumeister
authors.forename: T W
authors.initials: TW
authors.lastname: Anderson
mesh_terms: D000203:Activities of Daily Living; D002140:California / Q000453:epidemiology; D002423:Cause of Death; D016009:Chi-Square Distribution; D015331:Cohort Studies; D016001:Confidence Intervals; D003688:Deinstitutionalization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000401:mortality*; D008297:Male; D016012:Poisson Distribution; D012044:Regression Analysis; D012189:Retrospective Studies; D012306:Risk; D013997:Time Factors