Time trends in recording of intellectual disability in those admitted to a general hospital in England, 2005–2019.

F70–F79, codes for intellectual disability; F81.9, additional nonspecific code for developmental disorder of scholastic skills, unspecified. Error bars represent 95% confidence intervals.</p

Odds of intellectual disability being unrecorded in the general hospital record of adults with intellectual disability attending hospital (using a random effects model).

Odds of intellectual disability being unrecorded in the general hospital record of adults with intellectual disability attending hospital (using a random effects model).</p

Odds of intellectual disability being unrecorded in the general hospital record of adults with intellectual disability attending hospital (with multiple imputation for missing data).

Odds of intellectual disability being unrecorded in the general hospital record of adults with intellectual disability attending hospital (with multiple imputation for missing data).</p

Odds of intellectual disability being unrecorded in the general hospital record of adults with intellectual disability attending hospital (with multiple imputation for missing data).

Odds of intellectual disability being unrecorded in the general hospital record of adults with intellectual disability attending hospital (with multiple imputation for missing data).</p

Sensitivity of recording of intellectual disability in English general hospital records 2006–2019 for individual admissions and for individual patients by ICD-10 code group.

Sensitivity of recording of intellectual disability in English general hospital records 2006–2019 for individual admissions and for individual patients by ICD-10 code group.</p

Odds of intellectual disability being unrecorded in the general hospital record of adults with intellectual disability attending hospital.

Odds of intellectual disability being unrecorded in the general hospital record of adults with intellectual disability attending hospital.</p

Study protocol.

BackgroundAccurate recognition and recording of intellectual disability in those who are admitted to general hospitals is necessary for making reasonable adjustments, ensuring equitable access, and monitoring quality of care. In this study, we determined the rate of recording of intellectual disability in those with the condition who were admitted to hospital and factors associated with the condition being unrecorded.Methods and findingsRetrospective cohort study using 2 linked datasets of routinely collected clinical data in England. We identified adults with diagnosed intellectual disability in a large secondary mental healthcare database and used general hospital records to investigate recording of intellectual disability when people were admitted to general hospitals between 2006 and 2019. Trends over time and factors associated with intellectual disability being unrecorded were investigated. We obtained data on 2,477 adults with intellectual disability who were admitted to a general hospital in England at least once during the study period (total number of admissions = 27,314; median number of admissions = 5). People with intellectual disability were accurately recorded as having the condition during 2.9% (95% CI 2.7% to 3.1%) of their admissions. Broadening the criteria to include a nonspecific code of learning difficulty increased recording to 27.7% (95% CI 27.2% to 28.3%) of all admissions. In analyses adjusted for age, sex, ethnicity, and socioeconomic deprivation, having a mild intellectual disability and being married were associated with increased odds of the intellectual disability being unrecorded in hospital records. We had no measure of quality of hospital care received and could not relate this to the presence or absence of a record of intellectual disability in the patient record.ConclusionsRecognition and recording of intellectual disability in adults admitted to English general hospitals needs to be improved. Staff awareness training, screening at the point of admission, and data sharing between health and social care services could improve care for people with intellectual disability.</div

ICD-10 codes for specific disorders almost always associated with intellectual disability.

ICD-10 codes for specific disorders almost always associated with intellectual disability.</p

Demographics of adults with diagnosed intellectual disability admitted to an English general hospital during the study period (<i>n</i> = 2,477).

Demographics of adults with diagnosed intellectual disability admitted to an English general hospital during the study period (n = 2,477).</p

REporting of studies Conducted using Observational Routinely-collected Data (RECORD) guideline.

REporting of studies Conducted using Observational Routinely-collected Data (RECORD) guideline.</p