Abstract

People with intellectual/developmental disabilities (IDD) are reportedly intensive users of forensic inpatient services. Using administrative data, we identified people with and without IDD in forensic inpatient settings in Ontario, Canada over a ten-year period. We compared them on sociodemographic, clinical, and admission characteristics and post-discharge healthcare use to explore factors that could account for differences in forensic inpatient resource use. The prevalence of IDD in forensic inpatient settings was 16.7% (vs. 0.8% population prevalence). Those with IDD did use forensic inpatient services more intensively (more historical forensic admissions, longer lengths of stay, greater staff frustration). There were, however, few differences between forensic inpatients with and with IDD in their baseline sociodemographics, upon admission, during their index forensic episode, or in accessing post-discharge healthcare services. The only differences were that those with IDD had higher percentages of forensic inpatient episodes under review board (ORB) supervision and of delayed discharge from hospital in the year post-forensic-discharge. These findings are more consistent with system-level than individual-level explanations and suggest that increasing forensic inpatient and community-based resources for individuals with IDD may be critical for reducing the intensity of their forensic inpatient use and increasing the likelihood of successful transition to the community.

摘要

据报道，有智力/发育障碍 (IDD) 的人是法医住院服务的密集用户。使用管理数据，我们在十年内确定了加拿大安大略省法医住院机构中患有和未患有 IDD 的人。我们在社会人口学、临床和入院特征以及出院后医疗保健使用方面对它们进行了比较，以探索可能导致法医住院资源使用差异的因素。法医住院环境中 IDD 的患病率为 16.7%（与 0.8% 的人群患病率相比）。患有 IDD 的人确实更密集地使用法医住院服务（更多的历史法医入院、更长的住院时间、更大的员工挫败感）。然而，在入院时，患有和患有 IDD 的法医住院患者的基线社会人口统计数据几乎没有差异，在他们的索引法医事件期间，或在获得出院后的医疗保健服务期间。唯一的区别是，IDD 患者在审查委员会 (ORB) 监督下的法医住院发作和法医出院后一年延迟出院的比例更高。这些发现与系统层面的解释比个人层面的解释更一致，并表明增加 IDD 患者的法医住院和社区资源可能对于降低他们的法医住院使用强度和增加成功过渡到 IDD 的可能性至关重要。社区。唯一的区别是，IDD 患者在审查委员会 (ORB) 监督下的法医住院发作和法医出院后一年延迟出院的比例更高。这些发现与系统层面的解释比个人层面的解释更一致，并表明增加 IDD 患者的法医住院和社区资源可能对于降低他们的法医住院使用强度和增加成功过渡到 IDD 的可能性至关重要。社区。唯一的区别是，IDD 患者在审查委员会 (ORB) 监督下的法医住院发作和法医出院后一年延迟出院的比例更高。这些发现与系统层面的解释比个人层面的解释更一致，并表明增加 IDD 患者的法医住院和社区资源可能对于降低他们的法医住院使用强度和增加成功过渡到 IDD 的可能性至关重要。社区。