Ambulatory Care Sensitive Conditions in Persons with an Intellectual Disability - Development of a Consensus

Abstract

Background There is evidence that the primary care provided for persons with an intellectual disability living in the community has been inadequate. Hospitalization rates for ambulatory care sensitive (ACS) conditions are considered an indicator for access to, and quality of, primary care. The objective of this research was to identify ACS conditions that are applicable to persons with an intellectual disability. Materials and Methods We developed and distributed a survey questionnaire using a modified Delphi process. The participants were clinicians with experience working with people with an intellectual disability. Results All eleven conditions that were considered ACS for the general population met the three primary inclusion criteria. Study participants suggested five other conditions of which four met the primary criteria: constipation, gastroesophageal reflux, epilepsy, and schizophrenic disorders. Conclusions There is a very high degree of agreement as to what constitutes an ACS condition for persons with an intellectual disability. The final list has the potential to be used with other populations with cognitive disabilities and outside of Canada.