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Final Program


Final Program

110 - Difficult to discharge: Patients with Intellectual and Developmental Disabilities and complex care needs in an acute hospital setting

Thursday, February 27, 2025
5:00 PM - 6:30 PM MST
Objectives: Patients with intellectual and developmental disabilities (IDD) disproportionately experience longer hospital stays, subjecting them to an increased risk of negative health outcomes. As a part of a larger hospital task force, this study aimed to identify factors affecting length of stay (LOS) and review discharge outcomes for patients with long admissions.   

Design: A retrospective electronic chart review of patients with IDD with ≥ 30-day hospital LOS January 2023 through March 2024 was performed. Deidentified data collected included demographics, past social history, hospital course (diagnoses, procedures, complications), discharge details (destination, barriers, medical support needed).    

Results: Among 38 patients, average age was 35.8 years and 71% were male. 68.4% of patients were white; 47.4% were diagnosed with cerebral palsy. Using LOS as a continuous variable, p</span>atients without a primary care physician had an average LOS 33 days longer; patients without New York State Office for People with Developmental Disabilities (OPWDD) involvement had an average LOS 9 days longer. Those discharged home had shorter stays. Housing barriers and required new equipment extended LOS. Those admitted with a psychological chief complaint had an average stay of 170 days vs. the overall average of 69 days. 37% of admissions had consults with Physical Medicine & Rehabilitation (PMR) to assist with discharge.  

Conclusions: Key factors contributing to longer LOS included absence of a primary care physician, lack of OPWDD support, housing barriers, and additional equipment needs. Patients admitted for psychological concerns had longer stays, in part from required advanced psychological supports. Larger studies are needed to maximize statistical power and quantify observed relationships. These results emphasize the need for early discharge planning, possibly with PMR consultation assistance, for identification primarily of societal barriers and lack of supports for patients with complex diagnoses to optimize resource utilization and improve outcomes.