news
“ Healthcare is being driven by an administrative approach : completing paperwork rather than addressing medical needs .
Needs not being met
Health system ‘ unequipped ’ to care for those with intellectual disabilities .
By Eleanor Campbell
People with intellectual disabilities are hospitalised at significantly higher rates compared to the general population , according to an Australian-first study .
The analysis , published in the Medical Journal of Australia , spotlighted the critical gaps present in our healthcare system .
Researchers evaluated data from 92,542 individuals with an intellectual disability in NSW , comparing it to hospitalisation rates from the general population . It was found that those with an intellectual disability were at a 4.5 times higher risk of hospital admission for an avoidable condition .
The study ’ s lead author , Dr Janelle Weise from the Department of Developmental Disability Neuropsychiatry at UNSW Sydney , told Nursing Review that the findings were not surprising .
“ Historically , people with disabilities were put in institutions so they weren ’ t accessing community or hospital systems like the general population ,” she said .
“ What we saw when they moved out of these institutions and into the community was that mainstream services weren ’ t equipped to meet the needs of those with a disability .
“ This is what you see as a result : people being hospitalised for things that should have been picked up earlier or treated in the community .”
The study found that convulsions and epilepsy , conditions generally treated at home or in the community , led to 25.7 higher rates of hospital admissions .
Those with intellectual disabilities were also three times more likely to be hospitalised for a vaccine-preventable condition , such as the ‘ flu .
According to the latest senate estimates , just over one per cent of those in a disability care setting have had their first dose of the COVID-19 vaccine . Higher risks of contracting the virus paired with a lack of overall research on the subject is “ alarming ” according to Dr Weise .
“ There ’ s a reluctance among health professionals … there ’ s a lack of confidence and skills in this space for them to be able to modify their practice to meet the complex needs of someone with an intellectual disability .
“ Healthcare is being driven by an administrative approach : completing paperwork rather than addressing one ’ s medical needs , so that ’ s an indication of where things might be going awry .”
Past research has also identified a lack of depth in knowledge and training relating to the healthcare needs of people with intellectual disabilities in tertiary education .
“ If we looked at the content of medical curriculum and nursing curriculum , there ’ s a paucity of content ,” said Dr Weise .
“ It ’ s not surprising that you end up with a health workforce that isn ’ t sure , because they ’ re not taught it ,” she said .
High rates of preventative deaths are among the most serious implications of inadequate healthcare treatment and assessment for people with intellectual disabilities .
“ What our research shows is that they have higher rates of preventable death , that ’ s the worst case scenario . So they die younger from conditions that they didn ’ t need to die from .
“ We also see other people who are unable to engage in their lives and do the things they want to do because they have poor health .”
Research in the UK and Canada also demonstrates similar rates of preventative hospitalisations , suggesting the problem extends on a global scale .
In Australia , the ongoing royal commission has highlighted the links between restricted access to healthcare with the systemic abuse , neglect and exploitation of people with disabilities .
Earlier in May , the federal government finalised a roadmap for improving the health of the estimated 480,000 Australians who identify as having an intellectual disability . According to Dr Weise , much work needs to be done to further address the systemic inequalities embedded into the health system .
“ We ’ ve come such a long way since the 60s and 70s about speaking about people with disability and their role in society , and addressing their fundamental needs ,” said Dr Weise .
“ But I think we ’ re still chipping away at those undertones of attitude and beliefs . “ Hopefully we can get traction to try and address these fundamental rights that aren ’ t being upheld .” ■
6 | nursingreview . com . au