People with intellectual disability are at an unacceptably high risk of preventable hospitalisation.

A new study finds that people with intellectual disability are being hospitalised for conditions that could have been adequately managed in primary care or through prevention – at a rate 3.5 to 4.5 times higher than the general population.

The high rates of potentially preventable hospitalisations (PPH) are a symptom of the systemic neglect by the Australian healthcare system, experts say. 

“We already know from international research that people with intellectual disability experience higher rates of PPH – and that they generally face stark health inequalities and barriers to accessing health care,” says senior author Professor Julian Trollor from UNSW.

“But before our study, there hasn’t been any research into rates of PPH for Australians with intellectual disability.”

To address this evidence gap, the researchers analysed data collected over 15 years pertaining to 92,542 people with intellectual disability, and compared it to a cohort of the NSW general population.

“Our key finding is that people with intellectual disability in New South Wales experience higher PPH compared to the general population, which is unacceptable – they are 3.5 to 4.5 times more likely to be hospitalised for a condition that could have been managed through primary care or prevention,” says UNSW lead author Dr Janelle Weise.

People with intellectual disability were also found to be up to 25.7 times more likely to be hospitalised for convulsions and epilepsy compared to the NSW population – the biggest inequality uncovered in the study.

“And we also found that people with intellectual disability are up to three times more likely than the NSW population to be hospitalised for a vaccine-preventable condition,” Dr Weise says.

“It is critical that we look into why people with intellectual disability are being hospitalised for vaccine-preventable conditions, as we know that failure to vaccinate is also a factor associated with preventable deaths in people with intellectual disability.

“Particularly in light of the COVID-19 vaccine rollout, we need to address the barriers faced by people with intellectual disability to be vaccinated.”

The authors’ recommendations include a national population health strategy for people with intellectual disability and mandating reasonable adjustments in Australian health care to meet the needs of people with intellectual disability.

“We also need to equip the health care workforce in the area of intellectual disability health – and we need to make sure people with intellectual disability and their support networks have the tools to improve their health literacy,” Prof. Trollor says.

The researchers say preventable hospitalisations, higher multi-morbidity, and over-representation of premature and potentially avoidable deaths are just the tip of the iceberg which underlie a major gap in healthcare.