# 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

## TL;DR

People with intellectual or developmental disabilities or those who are deaf or hard of hearing have lower overall injury rates but higher rates of specific injuries like self-harm and falls compared to the general population.

## Contribution

This study provides new insights into injury patterns and healthcare costs for individuals with IDD or DHH using population-based data from Kentucky.

## Key findings

- Persons with IDD or DHH had lower overall injury rates but higher rates of self-harm, assault, falls, and drug poisonings.
- Injury-related healthcare charges for individuals with IDD or DHH were three times higher than for those without these disabilities.
- The study highlights the need for targeted health policy and clinical interventions to address injury risks in these populations.

## Abstract

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.

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.

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).

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.