Hospital readmissions among people with intellectual disabilities compared to the general population: a longitudinal register study (IDcare)

Background: People with Intellectual disabilities (ID) have more healthcare utilization, especially unplanned inpatient care. One reason could be too early hospital discharges, resulting in readmissions. This is an important aspect of quality of care that has not been thoroughly assessed among people with ID. Aim: To investigate readmission to hospital within 30 days among people with ID compared to the general population.Method: We included all people living in Skåne, Sweden, January 1st 2014. Those with a diagnosis of ID (F7 in ICD-10) or Down Syndrome (Q90), or with service and support for people with ID or autism spectrum disorder, comprised the ID cohort (n=14,716). Family/household members of people in the ID cohort were excluded. The remaining comprised the general population cohort (gPop; n=1,232,299). Data included inpatient care dates and diagnoses for a pre-pandemic (2014-2019) and a pandemic (2020-2021) period. This resulted in 1,228,325 inpatient registrations for the gPop cohort and 26,091 for the ID cohort. Results: People in the ID cohort had increased risk for having at least one readmission for the same diagnosis both before (RR 2.2, 95% CI 2.1-2.4) and during the pandemic (RR 2.8, 95% CI 2.5-3.2). The same pattern was seen for number of readmissions (RR 4.0 95% CI 3.8-4.2; RR 4.3 95% CI 4.0-4.7). The median number of days until readmission for the same diagnosis was 7 in the ID cohort (interquartile range 3-15) and 10 in the gPop (4-18). Conclusion: People with ID seem to have higher risks for readmission and are also readmitted sooner than the general population. This is likely not due to multimorbidity, as that would result in longer hospital stays rather than a readmission. The timing of discharge of people with ID needs to be planned more carefully.