The determinants of service complexity in children with intellectual disabilities.

Background To date, little is known about the predictors of healthcare service utilisation in children with intellectual disability (ID). The aim of this study was to identify the factors associated with service complexity in children with ID in Ontario, Canada. Methods The population of this cross-...

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Publicado en:Journal of Intellectual Disability Research Vol. 61; no. 11; pp. 1055 - 1069
Autores principales: Stewart, S. L., Falah Hassani, K., Poss, J., Hirdes, J.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Nov2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2017
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        atl: The determinants of service complexity in children with intellectual disabilities.
      aug:
        au:
          Stewart, S. L.
          Falah Hassani, K.
          Poss, J.
          Hirdes, J.
        affil: Faculty of Education, Western University, London Ontario, Canada
      sug:
        subj:
          Intellectual Disability Therapy
          Mental Health Services Utilization
          Health Resource Utilization Evaluation
          Ontario
          Human
          Child
          Adolescence
          Cross Sectional Studies
          Male
          Female
          Child, Preschool
          Clinical Assessment Tools
          Scales
          Autism Spectrum Disorder
          Bullying
          Victims
          Family Relations
          Aggression
          Communicative Disorders
          Learning Disorders
          Child: 6-12 years
          Adolescent: 13-18 years
          Child, Preschool: 2-5 years
          Male
          Female
      ab: Background To date, little is known about the predictors of healthcare service utilisation in children with intellectual disability (ID). The aim of this study was to identify the factors associated with service complexity in children with ID in Ontario, Canada. Methods The population of this cross-sectional study consisted of 330 children with ID ages 4 to 18 years who accessed mental health services from November of 2012 to June of 2016 in four agencies. All participants completed the interRAI Child and Youth Mental Health and Developmental Disability Assessment Instrument, which is a semi-structured clinician-rated assessment that covers a range of common issues in children with ID. The outcome of this study was a service complexity variable based on (1) mental health service utilisation including any services provided to the child and (2) the management involved in providing that care. Eight individual items were summed, resulting in a scale that ranged from 0 to 8. Scores were then dichotomised into two groups: a score of 0-2 identified children with a low service complexity and a score of 3 or higher identified children with a high service complexity. Results After adjustment for other covariates, gender was not associated with service complexity. Children aged 11-14 years and children with autism spectrum disorder used over twofold higher levels of service complexity than children aged equal to or less than 10 years or children with other causes of ID. Moreover, victims of bullying, high scores on the family functioning scale or learning or communication disorder were associated with greater service complexity. Conclusions The findings of this study indicate that a variety of factors are related to service complexity ranged from children's nonclinical (age and experiences of bullying) to clinical (e.g. aggression, learning/communication problems and autism spectrum disorder) characteristics.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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