Emergency medical care of people with intellectual and developmental disabilities. A systematic review

Ms Yvonne Wechuli1, Dr. Jana  York1, Prof. Dr. Ute Karbach1

1University of Cologne, Cologne, Germany

The suggested presentation reviews the situation of people with intellectual and developmental disabilities in emergency care. International research findings show their premature mortality and discrimination in health care, e.g., a “diagnostic overshadowing”: When intellectual and developmental disabilities as a “master category” overshadow health problems that are, in fact, independent of them, acute diseases are not diagnosed or insufficiently treated.

Preliminary results of a scoping review are presented that analyses all peer-reviewed papers focusing on people with intellectual and developmental disabilities in emergency care published in PubMed between 1st January 2009 and 1st February 2020. The studies’ quality is assessed via a checklist developed by the authors drawing on Zeng et al.’s compilation of common assessment tools for study quality.

14 quantitative studies fulfill the inclusion criteria for further analysis. Summary measures are extracted. Sample sizes vary between 28 and 66,484 cases. Ten studies are conducted in North America. All studies are of retrospective character; 10 out of 14 studies are cohort studies. Most studies defined their cases (10) and controls (6) based on secondary data. Results are synthesized with Anderson’s Behavioural Model of Health Service Use. Studies employ a combination of variables attributable to different aspects of population characteristics and health behaviour.

Most studies seek to quantify or predict emergency care overuse by people with intellectual and developmental disabilities. Future studies should also take patients’ poor health or treatment outcomes and their perspectives into account.


Yvonne Wechuli holds a M.A. in Rehabilitation Sciences from TU Dortmund University (Germany) and pursues a PhD in Disability Studies at the University of Cologne. Her other interests in research and teaching concern the participation of people with disabilities in different life areas, such as housing and health care.