Hospitalisations and deaths due to Ambulatory Care Sensitive Conditions (ACSC) among adults with and without Intellectual Disabilities in Scotland

BackgroundConditions that should be sufficiently managed in primary health care are collectively known as Ambulatory Care Sensitive Conditions (ACSC). The rate of unplanned hospital admissions for ACSC can be regarded as a proxy indicator of how well the primary care system works for a population of interest. We investigate such rates in Scotland, focusing on adults with Intellectual Disabilities (ID) and contrasting them with adults without ID. MethodA population-based retrospective cohort data linkage study of adult respondents to Scotlands 2011 Census. Self- or proxy-reported ID status from the Census was linked to hospital admissions data and deaths data. The cohort was followed until the end of 2019. ResultsAfter adjusting for different ACSC prevalence in ID and non-ID cohorts, we did not find evidence of there being a higher risk of unplanned ACSC hospitalisation among people with ID. COPD, seizures and epilepsy, influenza and pneumonia were responsible for half of ACSC hospitalisations, regardless of ID status. However, adults with ID had a higher risk of dying due to ACSC than adults without ID. ConclusionsWe conclude that overall, the primary care system in Scotland appears to be similarly effective for adults with ID than for adults without ID. However, the higher risk of dying from ACSC among people with ID needs further research.