| アブストラクト | BACKGROUND: Evidence on end-of-life care (EOLC) provision for people with intellectual disabilities in primary care is limited. METHODS: A retrospective cohort study of adults (18+ years) who died between 1 January 2010 and 31 March 2021 from linked Clinical Practice Research Datalink in England. Age- and gender-adjusted prevalence of comorbidities for people with and without IDs was compared by EOLC record assignment. Survival time and healthcare utilization after the first EOLC record was compared by ID status. Underlying cause of death was investigated. RESULTS: Of 1.1 million adults identified, 2147 (21.8%) with IDs and 313 847 (28.4%) without IDs (unadjusted) had an EOLC record. Among the ID population, those with an EOLC record had disproportionately higher prevalence of dysphagia [+6.5 percentage points (95% CI: 4.9, 8.1)] and dementia [+5.2 percentage points (3.9,6.7)] than those without an EOLC record. Survival after the first EOLC record was shorter for people with IDs compared to those without IDs: 26% [absolute risk: 0.26 (0.24, 0.28)] vs 16% [absolute risk: 0.16 (0.16, 0.17)] died within 7 days. Primary care and hospital utilization rates were also lower [incidence rate ratio 0.96 (0.84, 0.97) and 0.42 (0.41, 0.44), respectively]. The most common cause of death in the ID population was cancer (38% of all deaths) followed by chromosomal conditions (11%). CONCLUSIONS: EOLC needs in primary care appear to be identified later for people with IDs. Their primary and hospital healthcare utilization patterns are also lower, despite having unique and complex health needs. |
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| ジャーナル名 | Family practice |
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| Pubmed追加日 | 2026/4/1 |
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| 投稿者 | Tyrer, Freya; Miksza, Joanne; Zaccardi, Francesco; Gillies, Clare L; Khunti, Kamlesh; Borgstrom, Erica; Tilley, Elizabeth; Tuffrey-Wijne, Irene |
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| 組織名 | Leicester Real World Evidence Unit, Diabetes Research Centre, University of;Leicester, Leicester, LE5 4PW, United Kingdom.;Observational & Pragmatic Research Institute, Norwich, NR11 6UN, United Kingdom.;School of Health, Wellbeing & Social Care, The Open University, Milton Keynes,;MK7 6AA, United Kingdom.;Faculty of Health, Science, Social Care & Education, Kingston University,;Kingston-upon-Thames, KT2 7LB, United Kingdom. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41920963/ |
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