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dc.contributor.authorHughes-McCormack, Laura
dc.contributor.authorGreenlaw, Nicola
dc.contributor.authorMcSkimming, Paula
dc.contributor.authorMcCowan, Colin
dc.contributor.authorRoss, Kevin
dc.contributor.authorAllan, Linda
dc.contributor.authorHenderson, Angela
dc.contributor.authorMelville, Craig
dc.contributor.authorMorrison, Jill
dc.contributor.authorCooper, Sally-Ann
dc.identifier.citationHughes-McCormack , L , Greenlaw , N , McSkimming , P , McCowan , C , Ross , K , Allan , L , Henderson , A , Melville , C , Morrison , J & Cooper , S-A 2021 , ' Changes over time in the management of long-term conditions in primary health-care for adults with intellectual disabilities, and the health-care inequalities gap ' , Journal of Applied Research in Intellectual Disabilities , vol. 34 , no. 2 , pp. 634-647 .
dc.identifier.otherORCID: /0000-0002-9466-833X/work/85168525
dc.descriptionThis study was funded by the Scottish Government.en
dc.description.abstractBackground Quality of primary healthcare impacts on health outcomes. This study aimed to quantify trends in good practice and the healthcare inequalities gap. Method Indicators of best‐practice management of long‐term conditions and health promotion were extracted from primary healthcare records on 721 adults with intellectual disabilities in 2007–2010, and 3638 in 2014. They were compared over time, and with the general population in 2014, using Fisher's Exact test and ordinal regression. Results Management improved for adults with intellectual disabilities over time (OR = 5.32; CI = 2.69–10.55), but not for the general population (OR = 0.74; CI = 0.34–1.64). However, it remained poorer, but to a lesser extent, compared with the general population (OR = 0.38; CI = 0.20–0.73 in 2014, and OR = 0.05; CI = 0.02–0.12 in 2007–2010). In 2014, health care was comparable to the general population on 49/78 (62.8%) indicators. Conclusions The extent of the healthcare inequality gap reduced over this period, but remaining inequalities highlight that further action is still necessary.
dc.relation.ispartofJournal of Applied Research in Intellectual Disabilitiesen
dc.subjectChronic disease managementen
dc.subjectGeneral practiceen
dc.subjectIntellectual disabilitiesen
dc.subjectLong term conditionsen
dc.subjectPrimary careen
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subjectRC0321 Neuroscience. Biological psychiatry. Neuropsychiatryen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.titleChanges over time in the management of long-term conditions in primary health-care for adults with intellectual disabilities, and the health-care inequalities gapen
dc.typeJournal articleen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Sir James Mackenzie Institute for Early Diagnosisen
dc.contributor.institutionUniversity of St Andrews. Population and Behavioural Science Divisionen
dc.description.statusPeer revieweden

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