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  • Injury-related emergency department use among people with intellectual and developmental disabilities insured by Medicaid from 2010 to 2016

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Original research
Injury-related emergency department use among people with intellectual and developmental disabilities insured by Medicaid from 2010 to 2016
  1. Jessica Williams1,
  2. Julie Royer2,
  3. Emily Lauer3,
  4. Noelle K Kurth4,
  5. Willi Horner-Johnson5,
  6. Suzanne McDermott6,
  7. Anna Levy7,
  8. Jean P Hall8
  1. 1 Health Policy and Administration, The Pennsylvania State University, University Park, Pennsylvania, USA
  2. 2 Health and Demographics Division, South Carolina Revenue and Fiscal Affairs, Columbia, South Carolina, USA
  3. 3 Department of Family Medicine & Community Health, UMass Chan Medical School, Worcester, Massachusetts, USA
  4. 4 Institute for Health and Disability Policy Studies, University of Kansas College of Liberal Arts and Sciences, Lawrence, Kansas, USA
  5. 5 Institute on Development and Disability, Oregon Health & Science University, Portland, Oregon, USA
  6. 6 Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health & Health Policy, New York, New York, USA
  7. 7 Center for Health Systems Effectiveness, Oregon Health & Science University, Portland, Oregon, USA
  8. 8 Research and Training Center on Independent Living and the Institute for Health and Disability Policy Studies, University of Kansas College of Liberal Arts and Sciences, Lawrence, Kansas, USA
  1. Correspondence to Dr Jessica Williams, Health Policy and Administration, The Pennsylvania State University University Park, University Park, Pennsylvania, USA; jarw{at}psu.edu

Abstract

Objectives Data on non-fatal injuries and visits to the emergency department (ED) for injuries are not readily available. The objective of this paper is to describe injury-related ED visits for people with intellectual and developmental disabilities who are covered by the Medicaid insurance programme.

Methods We aggregated 2010–2016 Medicaid claims data from eight states. Using these data, we identified individuals with intellectual and developmental disabilities and then determined an all-cause ED visit rate, ED visit due to injury rate and admission from ED due to injury rate. Data were stratified by sex and age group. Results were compared with national rates.

Results Medicaid members with intellectual and developmental disabilities visited EDs at approximately 1.8 times the rate of the general population. The ED visit rate due to injury was approximately 1.5 times that observed in the population overall. When ED visits due to injury data were stratified by age and sex, the largest discrepancy was observed in women ages 45–64, who visited EDs due to injury at a rate 2.1 times that of women of the same age in the general population. The admission rate from ED due to injury increased over the study period most notably in the older age groups.

Conclusions While rates and patterns of ED utilisation among Medicaid members with intellectual and developmental disabilities vary by age and gender, our findings suggest this group visits the ED due to injury at rates well above the general population.

  • Descriptive Epidemiology
  • Barell Matrix
  • Surveillance
  • Disability
  • Injury Diagnosis

Data availability statement

Data may be obtained from a third party and are not publicly available. Each state ran their own analysis of Medicaid claims for their state. These data are not publicly available but can be requested from each state’s Medicaid programme.

https://doi.org/10.1136/ip-2023-045043

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. Each state ran their own analysis of Medicaid claims for their state. These data are not publicly available but can be requested from each state’s Medicaid programme.

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    Footnotes

    • Contributors JW, JR, EL, NKK, WH-J, SM, AL and JPH contributed to conception or design of the work. JR, JW, AL and EL contributed to data analysis. All contributed to data interpretation. JW, JR, EL, NKK, WH-J, SM and JPH contributed to drafting the article. All contributed to critical revision of the article and final approval of the version to be published. JR is the guarantor for this study.

    • Funding Funding was provided by the National Center on Birth Defects and Developmental Disabilities (CDC-RFA-DD16-1603).

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.