Hospitalisation for cancer and co‐morbidities among people with learning disability in Australia

Abstract

Accessible summary People with learning disability are just as likely as people in the general population to get cancer. In this study we have looked at how often clients who get cancer are admitted to hospital. We found that clients who get cancer are admitted to hospital much more often than clients who do not get cancer. We also looked at the experiences of two clients to show what clients have to go through when they get cancer. This research could help parents/carers and clients to know what to expect when people with learning disability need treatment and care for cancer. SummaryIn Australia, general health and medical services are subsidised by the government. This includes care for people with disabilities, screening and diagnostic services for common diseases, including cancer, and care and treatment for various medical conditions. In Western Australia, the majority of state‐provided health services are well documented in linkable databases. We have examined data from a large cohort of people receiving services for learning disability from the state and linked this with the state cancer registry and hospital records. While people with learning disability appear to be at similar risk for cancer, they may have poorer treatment outcomes as they already experience a range of health conditions which can exacerbate medical complications associated with treatment and/or other primary or secondary co‐morbid conditions. Our results show that the mean number of hospital admissions were higher for the cancer group, even when adjustments were made for conditions such as childhood leukaemia and renal dialysis both of which often require frequent hospitalisations. Multivariate regression analyses showed that younger age, female sex and severe or unspecified level of disability were significant contributors to the frequency of hospital admissions. Qualitative information gleaned from detailed chart reviews showed that in addition to considerable morbidity, some patients were admitted repeatedly either because of lack of supportive environments and/or lack of compliance with treatment. Issues in providing appropriate support services for individuals and their carers are discussed.