Are we making a difference in primary care for adults with intellectual and developmental disabilities?
Notice bibliographique
Résumé
In 2003, an International Think Tank on Reducing Health Disparities was held in Ottawa, Canada; it included representatives from Australia, Canada, Mexico, New Zealand, and the United States of America.The participants at that event identified individuals with disabilities (and intellectual and developmental disabilities (IDD) specifically) as one of 11 vulnerable populations with regards to being "more likely to become ill and less likely to receive appropriate care" (1).Individuals with IDD present with cognitive deficits associated with limitations in activities of daily living that begin in the developmental period, typically before the age of 18 years.As a group, they are at greater risk for health problems and for using resource-intensive health care services.However, because of their disabilities, they have greater difficulty negotiating their way through health services (2), ABSTRACTObjectives.To examine the impact of the dissemination of guidelines to physicians and of a population-level health communication intervention on the percentage of adults with intellectual and developmental disabilities (IDD) receiving preventive care through primary care.Methods.Noninstitutionalized adults with IDD in the province of Ontario, Canada, aged 40 to 64 years were matched to Ontarians without such disabilities each fiscal year (FY) from 2003 to 2016.Health administrative data were used to create a composite measure of receipt of recommended preventive primary care.Age-adjusted rates were used to assess trends, and average two-year rate ratios (RRs) and confidence intervals (CIs) were used to evaluate the effectiveness of the interventions.Results.The number of adults with IDD identified ranged from 20 030 in FY 2003 to 28 080 in FY 2016.The percentage of adults with IDD receiving recommended preventive primary care ranged from 43.4% in 2003 to 55.7% in 2015.Men with IDD had a 53.7% increase across the 13 years, while women with IDD only had a 30.9% increase.When evaluating the impact of the interventions, men with IDD were 4% more likely (RR: 1.04; 95% CI: 1.02-1.05) to receive recommended primary care in FY 2015 and FY 2016 as compared to FY 2009 and FY 2010; in contrast, women with IDD were 5% less likely (RR: 0.95; 95% CI: 0.93-0.98).A comparable drop was observed among women without IDD.Conclusions.Nearly 45% of adults with IDD in Ontario still do not receive recommended preventive care through primary care.Long-term impacts of the interventions introduced in the province may still occur over time, so ongoing monitoring is warranted.Special attention should be given to the preventive care needs of women with IDD.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,015 | 0,098 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,004 | 0,004 |
| Communication savante | 0,006 | 0,009 |
| Science ouverte | 0,004 | 0,005 |
| Intégrité de la recherche | 0,008 | 0,007 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,013 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».