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The British Journal of Psychiatry (2000) 176: 37-41
© 2000 The Royal College of Psychiatrists

Health care provision for people with a learning disability

Record-linkage study of epidemiology and factors contributing to hospital care uptake{dagger}

CHRISTOPHER L. MORGAN, MSc

Department of General Medicine, University Hospital of Wales, Cardiff

ZAHIR AHMED, MRCPsych

Department of Psychological Medicine, University of Wales College of Medicine, Cardiff

MICHAEL P. KERR, MRCPsych

Department of Psychological Medicine, University of Wales College of Medicine, Cardiff

Correspondence: Dr Michael Kerr, Department of Psychological Medicine, University Hospital of Wales, Heath Park, Cardiff CF4 4XW.Tel: 029 2069 4033; Fax: 029 2061 0812; e-mail: kerrmp{at}cf.ac.uk

Declaration of interest No conflict of interest. C.M. was partly funded by a grant from Glaxo-Wellcome.

{dagger} See editorial pp. 10—11, this issue.

Background We know little about how people with a learning disability access secondary health care.

Aims To describe the epidemiology of learning disability, the influence of deprivation on prevalence and the pattern of secondary care uptake, including the effect of institutionalisation.

Method A record-linkage study of secondary care contacts of 434 000 people between 1991 and 1997. A population with learning disability was identified; their secondary care contact was calculated and compared with the general population's.

Results The distribution of people with a learning disability (n = 1595) correlated significantly with deprivation. The presence of a learning disability hospital significantly affected care uptake. Place of residence also affected acute admission to the learning disability hospital. Former institution residents generated 212 admissions per 1000 patients; community patients generated 18 per 1000. The admission rate with any psychiatric diagnosis to any setting was 26.3 per 1000 people with a learning disability; 16.5% of such patients had a dual diagnosis.

Conclusions Health provision for people with a learning disability is affected by institutional provision.




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