Changes over time in the management of long-term conditions in primary health-care for adults with intellectual disabilities, and the health-care inequalities gap

Laura Hughes-McCormack; Nicola Greenlaw; Paula McSkimming; Colin McCowan; Kevin Ross; Linda Allan; Angela Henderson; Craig Melville; Jill Morrison; Sally-Ann Cooper

doi:10.1111/jar.12833

Changes over time in the management of long-term conditions in primary health-care for adults with intellectual disabilities, and the health-care inequalities gap

Laura Hughes-McCormack, Nicola Greenlaw, Paula McSkimming, Colin McCowan, Kevin Ross, Linda Allan, Angela Henderson, Craig Melville, Jill Morrison, Sally-Ann Cooper^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Background
Quality of primary healthcare impacts on health outcomes. This study aimed to quantify trends in good practice and the healthcare inequalities gap.

Method
Indicators of best‐practice management of long‐term conditions and health promotion were extracted from primary healthcare records on 721 adults with intellectual disabilities in 2007–2010, and 3638 in 2014. They were compared over time, and with the general population in 2014, using Fisher's Exact test and ordinal regression.

Results
Management improved for adults with intellectual disabilities over time (OR = 5.32; CI = 2.69–10.55), but not for the general population (OR = 0.74; CI = 0.34–1.64). However, it remained poorer, but to a lesser extent, compared with the general population (OR = 0.38; CI = 0.20–0.73 in 2014, and OR = 0.05; CI = 0.02–0.12 in 2007–2010). In 2014, health care was comparable to the general population on 49/78 (62.8%) indicators.

Conclusions
The extent of the healthcare inequality gap reduced over this period, but remaining inequalities highlight that further action is still necessary.

Original language	English
Pages (from-to)	634-647
Journal	Journal of Applied Research in Intellectual Disabilities
Volume	34
Issue number	2
Early online date	30 Nov 2020
DOIs	https://doi.org/10.1111/jar.12833
Publication status	Published - Mar 2021

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Chronic disease management
General practice
Health
Intellectual disabilities
Long term conditions
Primary care

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Hughes-McCormack-2020-Changes-over-time-JARID-AAM
Copyright © 2020 John Wiley & Sons Ltd. This work has been made available online in accordance with publisher policies or with permission. Permission for further reuse of this content should be sought from the publisher or the rights holder. This is the author created accepted manuscript following peer review and may differ slightly from the final published version. The final published version of this work is available at https://doi.org/10.1111/jar.12833.
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Hughes-McCormack, L., Greenlaw, N., McSkimming, P., McCowan, C., Ross, K., Allan, L., Henderson, A., Melville, C., Morrison, J., & Cooper, S.-A. (2021). Changes over time in the management of long-term conditions in primary health-care for adults with intellectual disabilities, and the health-care inequalities gap. Journal of Applied Research in Intellectual Disabilities, 34(2), 634-647. https://doi.org/10.1111/jar.12833

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title = "Changes over time in the management of long-term conditions in primary health-care for adults with intellectual disabilities, and the health-care inequalities gap",

abstract = "Background Quality of primary healthcare impacts on health outcomes. This study aimed to quantify trends in good practice and the healthcare inequalities gap. Method Indicators of best‐practice management of long‐term conditions and health promotion were extracted from primary healthcare records on 721 adults with intellectual disabilities in 2007–2010, and 3638 in 2014. They were compared over time, and with the general population in 2014, using Fisher's Exact test and ordinal regression. Results Management improved for adults with intellectual disabilities over time (OR = 5.32; CI = 2.69–10.55), but not for the general population (OR = 0.74; CI = 0.34–1.64). However, it remained poorer, but to a lesser extent, compared with the general population (OR = 0.38; CI = 0.20–0.73 in 2014, and OR = 0.05; CI = 0.02–0.12 in 2007–2010). In 2014, health care was comparable to the general population on 49/78 (62.8\%) indicators. Conclusions The extent of the healthcare inequality gap reduced over this period, but remaining inequalities highlight that further action is still necessary.",

keywords = "Chronic disease management, General practice, Health, Intellectual disabilities, Long term conditions, Primary care",

author = "Laura Hughes-McCormack and Nicola Greenlaw and Paula McSkimming and Colin McCowan and Kevin Ross and Linda Allan and Angela Henderson and Craig Melville and Jill Morrison and Sally-Ann Cooper",

note = "This study was funded by the Scottish Government.",

year = "2021",

month = mar,

doi = "10.1111/jar.12833",

language = "English",

volume = "34",

pages = "634--647",

journal = "Journal of Applied Research in Intellectual Disabilities",

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Hughes-McCormack, L, Greenlaw, N, McSkimming, P, McCowan, C, Ross, K, Allan, L, Henderson, A, Melville, C, Morrison, J & Cooper, S-A 2021, 'Changes over time in the management of long-term conditions in primary health-care for adults with intellectual disabilities, and the health-care inequalities gap', Journal of Applied Research in Intellectual Disabilities, vol. 34, no. 2, pp. 634-647. https://doi.org/10.1111/jar.12833

Changes over time in the management of long-term conditions in primary health-care for adults with intellectual disabilities, and the health-care inequalities gap. / Hughes-McCormack, Laura; Greenlaw, Nicola; McSkimming, Paula et al.
In: Journal of Applied Research in Intellectual Disabilities, Vol. 34, No. 2, 03.2021, p. 634-647.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Changes over time in the management of long-term conditions in primary health-care for adults with intellectual disabilities, and the health-care inequalities gap

AU - Hughes-McCormack, Laura

AU - Greenlaw, Nicola

AU - McSkimming, Paula

AU - McCowan, Colin

AU - Ross, Kevin

AU - Allan, Linda

AU - Henderson, Angela

AU - Melville, Craig

AU - Morrison, Jill

AU - Cooper, Sally-Ann

N1 - This study was funded by the Scottish Government.

PY - 2021/3

Y1 - 2021/3

N2 - Background Quality of primary healthcare impacts on health outcomes. This study aimed to quantify trends in good practice and the healthcare inequalities gap. Method Indicators of best‐practice management of long‐term conditions and health promotion were extracted from primary healthcare records on 721 adults with intellectual disabilities in 2007–2010, and 3638 in 2014. They were compared over time, and with the general population in 2014, using Fisher's Exact test and ordinal regression. Results Management improved for adults with intellectual disabilities over time (OR = 5.32; CI = 2.69–10.55), but not for the general population (OR = 0.74; CI = 0.34–1.64). However, it remained poorer, but to a lesser extent, compared with the general population (OR = 0.38; CI = 0.20–0.73 in 2014, and OR = 0.05; CI = 0.02–0.12 in 2007–2010). In 2014, health care was comparable to the general population on 49/78 (62.8%) indicators. Conclusions The extent of the healthcare inequality gap reduced over this period, but remaining inequalities highlight that further action is still necessary.

AB - Background Quality of primary healthcare impacts on health outcomes. This study aimed to quantify trends in good practice and the healthcare inequalities gap. Method Indicators of best‐practice management of long‐term conditions and health promotion were extracted from primary healthcare records on 721 adults with intellectual disabilities in 2007–2010, and 3638 in 2014. They were compared over time, and with the general population in 2014, using Fisher's Exact test and ordinal regression. Results Management improved for adults with intellectual disabilities over time (OR = 5.32; CI = 2.69–10.55), but not for the general population (OR = 0.74; CI = 0.34–1.64). However, it remained poorer, but to a lesser extent, compared with the general population (OR = 0.38; CI = 0.20–0.73 in 2014, and OR = 0.05; CI = 0.02–0.12 in 2007–2010). In 2014, health care was comparable to the general population on 49/78 (62.8%) indicators. Conclusions The extent of the healthcare inequality gap reduced over this period, but remaining inequalities highlight that further action is still necessary.

KW - Chronic disease management

KW - General practice

KW - Health

KW - Intellectual disabilities

KW - Long term conditions

KW - Primary care

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U2 - 10.1111/jar.12833

DO - 10.1111/jar.12833

M3 - Article

SN - 1360-2322

VL - 34

SP - 634

EP - 647

JO - Journal of Applied Research in Intellectual Disabilities

JF - Journal of Applied Research in Intellectual Disabilities

IS - 2

ER -

Changes over time in the management of long-term conditions in primary health-care for adults with intellectual disabilities, and the health-care inequalities gap

Abstract

UN SDGs

Keywords

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