Comprehensive preventive care assessments for adults with intellectual and developmental disabilities: Part 1: How do we know if it is happening?

OBJECTIVE:To determine how best to measure the provision of comprehensive preventive care assessment of adults with intellectual and developmental disabilities (IDD). DESIGN:Cross-sectional study. SETTING:Ontario. PARTICIPANTS:Adults with IDD between 40 and 64 years of age in 2013 and 2014. MAIN OUTCOME MEASURES:Health examination was defined using the Ontario Health Insurance Plan billing data fee code A003 (with diagnostic code 917 or 319) or fee code K131, and the Primary Care Quality Composite Score (PCQS), a measure combining 7 different screening maneuvers (lipid, glucose, breast cancer, cervical cancer, colorectal cancer, eye, and hemoglobin A1c screening), was identified using administrative health data. RESULTS:A total of 28 825 adults with IDD were identified in 2013 and 2014. Overall, 12.1% of adults with IDD received a health examination; 51.2% received a high (≥ 0.6) PCQS. Male patients were more likely to have received all of their eligible screening maneuvers if they had had a health examination compared with female patients (odds ratio of 5.73 vs 3.99, respectively). CONCLUSION:Less than 60% of adults with IDD appear to be receiving comprehensive preventive care. Future studies assessing the quality of preventive care received by adults with IDD should combine health examination billing codes and the PCQS.