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. 2025 Apr 3;17(4):e81667.
doi: 10.7759/cureus.81667. eCollection 2025 Apr.

Emergency Department Utilization Among Adults With Intellectual and Developmental Disabilities: A Comparison of Those Using the Program for Adults With Intellectual and Developmental Disabilities and Those Using Alternative Primary Care Clinics

Jeremy M Williams  1 , Kendyll Coxen  2 , Carlos Palacio  1 , Rafik Jacob  3
Affiliations

Emergency Department Utilization Among Adults With Intellectual and Developmental Disabilities: A Comparison of Those Using the Program for Adults With Intellectual and Developmental Disabilities and Those Using Alternative Primary Care Clinics

Jeremy M Williams et al. Cureus. .

Abstract

Adults with intellectual and developmental disabilities (IDD) experience higher rates of emergency department (ED) utilization compared to the general population due to complex medical needs, healthcare access barriers, and social determinants of health. Although prior research has identified predictors of ED use, including socioeconomic status, primary care continuity, and housing stability, the role of specialized primary care programs in reducing reliance on emergency services remains understudied. This study examines the impact of the Program for Adults With Intellectual and Developmental Disabilities (PAIDD) at the University of Florida (UF) Health Jacksonville on ED utilization rates among adults with IDD. Using a retrospective cohort design, we compared ED visit frequencies between PAIDD patients and a control group of adults with IDD who receive care outside the program. Additionally, we explored whether housing status, living with family, independently, or in a facility, affects ED utilization. Findings revealed a statistically significant reduction in ED visits among PAIDD patients compared to the control group (p=0.004), suggesting that structured, multidisciplinary healthcare models improve continuity of care and reduce avoidable ED utilization. However, housing status alone did not emerge as an independent predictor of ED use (p=0.093), indicating that other factors, such as access to primary care and caregiver support, may play a greater role. These results underscore the need for expanded university-based IDD healthcare programs to bridge gaps in care, enhance preventive health strategies, and reduce emergency healthcare dependence in this population. The study supports the integration of dedicated IDD clinics in academic medical centers to improve long-term health outcomes and health equity for individuals with IDD.

Keywords: adults with intellectual and developmental disabilities; emergency department utilization; health care quality improvement; healthcare policy; preventative care strategies; social determinants of health (sdoh); university of florida.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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