title: Health characteristics and consultation patterns of people with intellectual disability: a cross-sectional database study in English general practice.
abstract: BACKGROUND
  People with intellectual disability (ID) are a group with high levels of healthcare needs; however, comprehensive information on these needs and service use is very limited.
  
  
  OBJECTIVE
  To describe chronic disease, comorbidity, disability, and general practice use among people with ID compared with the general population.
  
  
  METHODS
  This study is a cross-sectional analysis of a primary care database including 408 English general practices in 2012.
  
  
  METHODS
  A total of 14 751 adults with ID, aged 18-84 years, were compared with 86 221 age-, sex- and practice-matched controls. Depending on the outcome, prevalence (PR), risk (RR), or odds (OR) ratios comparing patients with ID with matched controls are shown.
  
  
  RESULTS
  Patients with ID had a markedly higher prevalence of recorded epilepsy (18.5%, PR 25.33, 95% confidence interval [CI] = 23.29 to 27.57), severe mental illness (8.6%, PR 9.10, 95% CI = 8.34 to 9.92), and dementia (1.1%, PR 7.52, 95% CI = 5.95 to 9.49), as well as moderately increased rates of hypothyroidism and heart failure (PR>2.0). However, recorded prevalence of ischaemic heart disease and cancer was approximately 30% lower than the general population. The average annual number of primary care consultations was 6.29 for patients with ID, compared with 3.89 for matched controls. Patients with ID were less likely to have longer doctor consultations (OR 0.73, 95% CI = 0.69 to 0.77), and had lower continuity of care with the same doctor (OR 0.77, 95% CI = 0.73 to 0.82).
  
  
  CONCLUSIONS
  Compared with the general population, people with ID have generally higher overall levels of chronic disease and greater primary care use. Ensuring access to high-quality chronic disease management, especially for epilepsy and mental illness, will help address these greater healthcare needs. Continuity of care and longer appointment times are important potential improvements in primary care.
authors.affiliation: Population Health Research Institute, St George's, University of London, London.
authors.forename: Iain M
authors.initials: IM
authors.lastname: Carey
authors.affiliation: Population Health Research Institute, St George's, University of London, London.
authors.forename: Sunil M
authors.initials: SM
authors.lastname: Shah
authors.affiliation: Population Health Research Institute, St George's, University of London, London.
authors.forename: Fay J
authors.initials: FJ
authors.lastname: Hosking
authors.affiliation: Population Health Research Institute, St George's, University of London, London.
authors.forename: Stephen
authors.initials: S
authors.lastname: DeWilde
authors.affiliation: Population Health Research Institute, St George's, University of London, London.
authors.forename: Tess
authors.initials: T
authors.lastname: Harris
authors.affiliation: Faculty of Heath Social Care and Education, Kingston and St George's, University of London, London.
authors.forename: Carole
authors.initials: C
authors.lastname: Beighton
authors.affiliation: Population Health Research Institute, St George's, University of London, London.
authors.forename: Derek G
authors.initials: DG
authors.lastname: Cook
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice / Q000379:methods / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012017:Referral and Consultation; D006113:United Kingdom / Q000453:epidemiology
keywords: chronic disease; continuity of care; intellectual disability; learning disabilities; primary care