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1.
Health Aff (Millwood) ; 41(10): 1505-1512, 2022 10.
Article in English | MEDLINE | ID: covidwho-2054399

ABSTRACT

Pandemic-related disruptions in access to medical care services, along with elevated rates of comorbidity, increase the risk for severe illness and death from COVID-19 for people with disabilities. Analyzing data from the 2020 National Health Interview Survey, we examined the impact of the COVID-19 pandemic on adults' access to medical care services by presence and type of disability. Adults with disabilities, including in each disability category, experienced significant disparities in delayed and unmet need for medical care during the first year of the COVID-19 pandemic. Improving data collection on disabled Americans according to disability status and type of disability, designating people with disabilities as a Special Medically Underserved Population under the Public Health Services Act, and incorporating standardized disability data in electronic health record systems would inform policies, programs, and interventions to achieve equitable access to high-quality medical care services that meet the needs of all people with disabilities during the COVID-19 pandemic and beyond.


Subject(s)
COVID-19 , Disabled Persons , Adult , COVID-19/epidemiology , Health Services Accessibility , Humans , Pandemics , Patient Care , United States/epidemiology
2.
Popul Health Manag ; 25(3): 335-342, 2022 06.
Article in English | MEDLINE | ID: covidwho-1532423

ABSTRACT

Emerging evidence on the disproportionate impact of COVID-19 on people with intellectual and developmental disabilities (IDD) points to the underlying risk and burden of infectious diseases (IDs) in this population. The objective of this study was to examine the risk of ID-related emergency department (ED) visits, subsequent hospitalizations, and hospital-based mortality during ID-related visits among adults with IDD compared to those without IDD. The authors conducted a retrospective study using data from the 2016 Nationwide Emergency Department Sample. The sample included 94,928 adults with IDD identified using ICD-10-CM codes, and age- and sex-matched 284,763 non-IDD adults in a 1:3 case-control ratio. A Poisson regression model was used to compare the risk of ID-related ED visits, subsequent hospitalizations, and hospital-based mortality during ID-related visits between adults with and without IDD. Covariates included sociodemographic and hospital characteristics. Results showed that adults with IDD are at a higher risk for ID-related ED visits, subsequent hospitalization, and mortality during ID-related ED visits compared to non-IDD adults. Adults with IDD continued to experience higher risks even after accounting for sociodemographic, hospital, and clinical characteristics. Septicemia and respiratory tract infections are the leading causes of ED visits, hospitalization, and mortality. This study found substantial disparities in ID-related ED visits, subsequent hospitalization, and mortality among the burdens for adults with IDD. These observations underscore the importance of integrated strategies to reduce ID-related morbidity among adults with IDD.


Subject(s)
COVID-19 , Communicable Diseases , Intellectual Disability , Adult , COVID-19/epidemiology , Child , Developmental Disabilities/epidemiology , Emergency Service, Hospital , Hospitalization , Humans , Intellectual Disability/epidemiology , Middle Aged , Retrospective Studies , United States/epidemiology
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