Nonfatal injury emergency department visits and inpatient hospitalizations among persons under age 65 with an intellectual and developmental disability or deaf or hard of hearing disability

Abstract Background Vulnerable populations at risk of injury include persons with intellectual and developmental disabilities (IDD), and persons who are deaf or hard of hearing (DHH). The purpose of this study was to describe and compare emergency department and inpatient hospitalization (ED + IP) i...

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Main Authors: Terry L. Bunn, Jacqueline Seals, Dana Quesinberry, Alaina Murphy, Julia F. Costich
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Injury Epidemiology
Online Access:https://doi.org/10.1186/s40621-025-00580-2
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author Terry L. Bunn
Jacqueline Seals
Dana Quesinberry
Alaina Murphy
Julia F. Costich
author_facet Terry L. Bunn
Jacqueline Seals
Dana Quesinberry
Alaina Murphy
Julia F. Costich
author_sort Terry L. Bunn
collection DOAJ
description Abstract Background Vulnerable populations at risk of injury include persons with intellectual and developmental disabilities (IDD), and persons who are deaf or hard of hearing (DHH). The purpose of this study was to describe and compare emergency department and inpatient hospitalization (ED + IP) injury rates and rate ratios by injury type among persons under age 65 with IDD or with DHH to those without IDD or DHH. Methods This is a descriptive population-based retrospective cross-sectional study of injuries among patients under the age of 65 with an IDD disability or a DHH disability using Kentucky ED + IP discharge datasets from 2019 to 2023. Injury rates and injury rate ratios were calculated for those under the age of 65 with an IDD or a DHH disability and without an IDD or a DHH disability, using number of persons under age 65 with or without the related disability as the denominator. Results The overall injury rate was lower for persons under age 65 with an IDD or DHH compared to those without those disabilities in 2023 (1 and 3 per 100,000 population, respectively). IDD or DHH disability types had significantly lower overall ED + IP injury rate ratios compared to those without those disabilities (IDD: 0.667 [95% CI: 0.640–0.694], DHH: 0.658 [95% CI: 0.633–0.683]). When ED + IP injury type rate ratios were compared, IDD or DHH persons had higher injury rate ratios for self-harm (IDD: 8.740 [95% CI: 7.783–9.815], DHH: 1.7846 [95% CI: 1.402–2.272]), assault (IDD: 1.386 [95% CI: 1.173–1.637], DHH: 1.310 [95% CI: 1.115–1.540]), unintentional falls (IDD: 1.540 [95% CI: 1.436–1.633], DHH: 1.283 [95% CI: 1.201–1.372]), and drug poisonings (IDD: 2.401 [95% CI: 2.103–2.740], DHH:1.620 [95% CI: 1.391–1.886]) compared to those without such disabilities. Those with IHH or DHH who were treated for injuries incurred triple the charges of patients without these conditions (~$17,086 IDD; $19,550 DHH; and $5,216 no IDD or DHH disabilities). Conclusions These findings have implications for health policy at the state and federal level. Clinical care interventions to reduce assault, self-harm, drug poisonings and unintentional injuries and healthcare utilization in persons with IDD or DHH should be publicly funded or covered by health insurance.
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spelling doaj-art-de8e62c8ed6449baa7db76bb2cca6dfa2025-08-20T01:49:37ZengBMCInjury Epidemiology2197-17142025-05-011211910.1186/s40621-025-00580-2Nonfatal injury emergency department visits and inpatient hospitalizations among persons under age 65 with an intellectual and developmental disability or deaf or hard of hearing disabilityTerry L. Bunn0Jacqueline Seals1Dana Quesinberry2Alaina Murphy3Julia F. Costich4Department of Epidemiology and Environmental Health, University of Kentucky College of Public HealthKentucky Injury Prevention and Research Center, University of Kentucky College of Public HealthKentucky Injury Prevention and Research Center, University of Kentucky College of Public HealthKentucky Injury Prevention and Research Center, University of Kentucky College of Public HealthKentucky Injury Prevention and Research Center, University of Kentucky College of Public HealthAbstract Background Vulnerable populations at risk of injury include persons with intellectual and developmental disabilities (IDD), and persons who are deaf or hard of hearing (DHH). The purpose of this study was to describe and compare emergency department and inpatient hospitalization (ED + IP) injury rates and rate ratios by injury type among persons under age 65 with IDD or with DHH to those without IDD or DHH. Methods This is a descriptive population-based retrospective cross-sectional study of injuries among patients under the age of 65 with an IDD disability or a DHH disability using Kentucky ED + IP discharge datasets from 2019 to 2023. Injury rates and injury rate ratios were calculated for those under the age of 65 with an IDD or a DHH disability and without an IDD or a DHH disability, using number of persons under age 65 with or without the related disability as the denominator. Results The overall injury rate was lower for persons under age 65 with an IDD or DHH compared to those without those disabilities in 2023 (1 and 3 per 100,000 population, respectively). IDD or DHH disability types had significantly lower overall ED + IP injury rate ratios compared to those without those disabilities (IDD: 0.667 [95% CI: 0.640–0.694], DHH: 0.658 [95% CI: 0.633–0.683]). When ED + IP injury type rate ratios were compared, IDD or DHH persons had higher injury rate ratios for self-harm (IDD: 8.740 [95% CI: 7.783–9.815], DHH: 1.7846 [95% CI: 1.402–2.272]), assault (IDD: 1.386 [95% CI: 1.173–1.637], DHH: 1.310 [95% CI: 1.115–1.540]), unintentional falls (IDD: 1.540 [95% CI: 1.436–1.633], DHH: 1.283 [95% CI: 1.201–1.372]), and drug poisonings (IDD: 2.401 [95% CI: 2.103–2.740], DHH:1.620 [95% CI: 1.391–1.886]) compared to those without such disabilities. Those with IHH or DHH who were treated for injuries incurred triple the charges of patients without these conditions (~$17,086 IDD; $19,550 DHH; and $5,216 no IDD or DHH disabilities). Conclusions These findings have implications for health policy at the state and federal level. Clinical care interventions to reduce assault, self-harm, drug poisonings and unintentional injuries and healthcare utilization in persons with IDD or DHH should be publicly funded or covered by health insurance.https://doi.org/10.1186/s40621-025-00580-2
spellingShingle Terry L. Bunn
Jacqueline Seals
Dana Quesinberry
Alaina Murphy
Julia F. Costich
Nonfatal injury emergency department visits and inpatient hospitalizations among persons under age 65 with an intellectual and developmental disability or deaf or hard of hearing disability
Injury Epidemiology
title Nonfatal injury emergency department visits and inpatient hospitalizations among persons under age 65 with an intellectual and developmental disability or deaf or hard of hearing disability
title_full Nonfatal injury emergency department visits and inpatient hospitalizations among persons under age 65 with an intellectual and developmental disability or deaf or hard of hearing disability
title_fullStr Nonfatal injury emergency department visits and inpatient hospitalizations among persons under age 65 with an intellectual and developmental disability or deaf or hard of hearing disability
title_full_unstemmed Nonfatal injury emergency department visits and inpatient hospitalizations among persons under age 65 with an intellectual and developmental disability or deaf or hard of hearing disability
title_short Nonfatal injury emergency department visits and inpatient hospitalizations among persons under age 65 with an intellectual and developmental disability or deaf or hard of hearing disability
title_sort nonfatal injury emergency department visits and inpatient hospitalizations among persons under age 65 with an intellectual and developmental disability or deaf or hard of hearing disability
url https://doi.org/10.1186/s40621-025-00580-2
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