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Health services and associated costs for adults with intellectual and developmental disabilities (IDD) were nationally profiled and the predictors of high expense users statistically modeled. Using linked data from the National Health Interview Survey and Medical Expenditure Panel Survey for the years 2002 through 2011, the study found a mixed pattern of differences in rates of service use and costs when compared to the general population depending upon personal characteristics, health status, and type of health care service. Prescription medication costs were the primary driver of total health care expenditures for Americans with IDD. The presence of secondary chronic health conditions and poor mental health status were the consistent predictors of high expense users across types of health care. Study results are discussed in terms of implications for more nuanced evaluations of health care costs and need for recurring surveillance of health care for Americans with IDD in the years following passage of the Patient Protection and Affordable Care Act. [ABSTRACT FROM AUTHOR]

Background: U.S. adults with intellectual and developmental disabilities (IDD) have poorer health status and greater risks for being overweight and obese, which are major drivers of health care expenditures in the general population. Health care expenditures and IDD have not been studied using nationally representative samples, and the impact of overweight and obesity have not been examined.Aim: Using nationally representative data, we aimed to compare the health care expenditures of not-overweight, overweight and obese U.S. adults with IDD, and calculate model-adjusted expenditures.Methods and Procedures: Pooled data from the 2002-2011 Medical Expenditure Panel Survey linked to National Health Interview Survey (n = 1224) were analyzed. Two-part model regressions were conducted, with covariates being year of survey, age, sex, race/ethnicity, household income status, geographical region, urban/rural, marital status, insurance coverage, perceived health status, and perceived mental health status.Outcomes and Results: Overall, obese adults with intellectual and developmental disabilities had higher expenditures than their non-obese peers. Being obese was associated with an estimated additional $2516 in mean expenditures and $1200 in median expenditures compared with the reference group, who were neither overweight nor obese.Conclusions and Implications: Obesity is an important predictor of higher health care costs among community-living adults with IDD Finding effective strategies and interventions to address obesity in this population has great financial and policy significance. [ABSTRACT FROM AUTHOR]

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The author comments on the publication of qualitative research on intellectual and developmental disabilities and the high rejection rates of the publication. He discusses the elements of qualitative research which include transparency and the use of quotations. He suggests potential authors to research various resources essential in conducting and reporting qualitative research. [ABSTRACT FROM AUTHOR]

The forces shaping intellectual disability policy-making are diverse; while many of the policy issues reviewed in this issue are specific to intellectual disabilities, there are others that transcend disability-specific concerns. Our review is organized around six emerging demographic and socio-cultural trends that may directly and profoundly impact the intellectual disability field: aging, changing labor markets, immigration, families, federalism, and culture. Each of these trends is discussed in terms of their relevance and potential impact on disability policy. © 2007 Wiley-Liss, Inc. MRDD Research Reviews 2007;13:188–194. [ABSTRACT FROM AUTHOR]

This article discusses the review of an article written by Kevin Walsh and Theodore Kastner for "The American Association of Mental Retardation" journal. Walsh and Kastner wrote an article about alleged errors and discrepancies in the manuscript "The Hissom Closure Outcomes Study: A Report on Six Years of Movement to Supported Living," by James Conroy, Scott Spreat, Anita Yuskaukas, and Martin Elks in the August 2003 issue of the journal. The article explains the opinions of Walsh, Kastner and, Conroy et al.

Background The imbalance between the sheer size of the developing world and what little is known about the lives and life circumstances of persons with disabilities living there should command our attention. Method International development initiatives routinely give great priority to the collection of statistical indicators yet even the most basic data on intellectual disability is lacking. In response to the recent adoption of the ‘international classification of function’, numerous initiatives are attempting to expand and improve the quality of disability surveillance. Results We argue that these efforts must not lose sight of the core focus and promise of disability statistics – that of advocacy and the elevation of a disability policy agenda. Conclusions To this end, we weave throughout our analysis of the technical features of surveillance, reflections on the meanings we attach to disability statistics and by extension, disability itself. [ABSTRACT FROM AUTHOR]

The article presents a comparative analysis by researchers at the University of Illinois in Chicago that identified trends in mental retardation and developmental disabilities spending in the U.S. from fiscal years 1977 to 1986. Budgets for community services and institutional operations were among the trends identified in the study and their implications were further discussed in detail.

A profile of the demography of individuals with mental retardation and related developmental disabilities (MR/DD) was developed from the Survey of Income and Program Participation, a national household survey. We estimated a total 1991 population of 2.97 million Americans with MR/DD, with 2.63 million living outside the formal long-term care system. Observations suggest that (a) families are the dominant form of support and, thus, a key constituency in disability policy; (b) a large cohort currently live in households headed by aging family members; and (c) there are significant economic disparities between subgroups of families, defined primarily along gender and racial lines. [ABSTRACT FROM AUTHOR]

"Out-of-pocket" spending by families supporting an adult family member with mental retardation or related developmental disability was characterized and estimated. Annualized nonreimbursed spending among a sample of 99 Chicago-area households was evaluated through survey and telephone interview across 10 categories of routine daily living expenses and disabilities-related services. The average annual out-of-pocket cost was $6,348. Average pre-tax income for the sample households was $37,657. Although wealthier households reported higher levels of spending, the percentage of household income represented by out-of-pocket costs increased significantly as family incomes decreased. Results were discussed in the context of families as a focus for service planning and public policy and the importance of the family to the nation's system of care. [ABSTRACT FROM AUTHOR]

Cardiovascular risk factors in a population of adults with mental retardation were examined. The subjects resided in three types of settings (16+ bed facility, group home, and natural family) and were measured on the following parameters: blood lipids, obesity, and smoking. The data were compared to a nonretarded population and to the guidelines established by the National Cholesterol Education Program. Results indicated that adults with mental retardation had cardiovascular risk profiles similar to those of individuals without mental retardation in the Framingham Offspring Study and that to the extent that cardiovascular health is a concern to the general population, it must also be a concern for individuals with mental retardation. [ABSTRACT FROM AUTHOR]

Results of a national study of state-operated institutional care in the United States were presented. The relations among census reduction, staffing level, and resident cost were explored. Resident cost escalated dramatically in recent years, primarily because staffing levels in the states remained relatively stable, whereas the institutional census continued to decline. Econometric projections suggest that by the year 2000, the institutional census will fall below 55,000 persons, cost per resident will rise to more than $113,000 per year, and 28 to 51 institutions will close. [ABSTRACT FROM AUTHOR]

Data emanating from the community services component of the Third National Stud-p of Public Spending for Mental Retardation and Developmental Disabilities was analyzed. An empirical model of community services spending in the states was tested in a hierarchical regression analysis using cumulative community services fiscal effort in the states across 1977–1988 as the dependent variable. Strength of consumer advocacy organizations in the states coupled with states' historical orientations toward the adoption of policies promoting racial equality were highly significant predictors of state-by-state variance in community spending patterns. The implications of this and other findings emerging from the national study were discussed. [ABSTRACT FROM AUTHOR]