NYMC Student Theses and Dissertations
Adults with I/DD and Secondary Gastrointestinal Conditions: An Analysis of Healthcare Utilization Patterns and Clinical Characteristics, and Implications for Patient-Centered Delivery Innovations
Abstract
An innovation imperative exists to transform care provision and research design for populations with intellectual and developmental disabilities (I/DD). This study’s 2 objectives addressed this innovation imperative. Latent Class Analysis (LCA) was used to classify, describe, and compare clinically heterogeneous subpopulations underlying an adult I/DD population with secondary gastrointestinal (GI) conditions. An infrastructure assessment was used to determine the extent of GI-focused care provided at WIHD that was aligned with the PCMH model for disorders of gut-brain interaction (DGBI-PCMH). LCA results revealed two subgroups underlying the single study sample: a High Comorbidity Burden subgroup (38%), and a High GI Burden subgroup (62%). The former subgroup had higher probabilities of obesity, hypertension, hypercholesterolemia, diabetes, epilepsy/seizure disorder, being verbal, and was more likely to take six of the eleven medications linked to inducing GI disorders. The latter subgroup was more likely to sustain 3 of the 4 GI diagnosis categories studied and to have obsessive-compulsive disorder. DGBI-PCMH assessment revealed the need for a physician champion, preventive care protocols, and team-based care dynamics. Reconstructing care protocols to target each subgroup’s different healthcare profiles by using a GI physician champion, team-based care, and by incorporating the biopsychosocial model to restructure care protocols can facilitate improved healthcare delivery and quality of life outcomes for adult-GI patients serviced by WIHD.
