title: Day Service Provision for People with Intellectual Disabilities: A Case Study Mapping 15-Year Trends in Ireland.
abstract: BACKGROUND
  Day services for people with intellectual disabilities are experiencing a global paradigm shift towards innovative person-centred models of care. This study maps changing trends in day service utilization to highlight how policy, emergent patterns and demographic trends influence service delivery.
  
  
  METHODS
  National intellectual disability data (1998-2013) were analysed using WINPEPI software and mapped using QGIS Geographic Information System.
  
  
  RESULTS
  Statistically significant changes indicated fewer people availing of day services as a proportion of the general population; more males; fewer people aged <35; a doubling in person-centred plans; and an emerging urban/rural divide. Day services did not change substantially and often did not reflect demand.
  
  
  CONCLUSIONS
  Emergent trends can inform future direction of disability services. Government funds should support individualized models, more adaptive to changing trends. National databases need flexibility to respond to policy and user demands. Future research should focus on day service utilization of younger people and the impact of rurality on service availability, utilization, quality and migration.
authors.affiliation: Mental Health and Social Research Unit, Maynooth University Department of Psychology, National University of Ireland Maynooth, Ireland.
authors.forename: Padraic
authors.initials: P
authors.lastname: Fleming
authors.affiliation: Mental Health and Social Research Unit, Maynooth University Department of Psychology, National University of Ireland Maynooth, Ireland.
authors.forename: Sinead
authors.initials: S
authors.lastname: McGilloway
authors.affiliation: Centre for Health Policy and Management, School of Medicine, Trinity College, Dublin, Ireland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Barry
keywords: day services; implementation; individ-ualized support; intellectual disability; person-centred plan; personal budget