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

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.