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Hospitalization Rate and Days Spent at Home as Value-Based Outcome Measures for People with Intellectual and Developmental Disability

William R Mills, Kendall Law, Ronald Boyd, Wes Cronkite, Shauen Howard, Sheryl Zerbe, Robert Barnes, Susan Sender and Laurie Babin

Background: Although there has been increased usage of value based outcome measures, there is little research about which measures should be used for people with intellectual and developmental disabilities (IDD). Methods: We performed a retrospective review of an internal census and length of stay database for individuals with IDD for whom we provided continuous residential support services between October 1, 2018 and September 30, 2019. Hospitalization rate and inpatient days per 1,000 were calculated using standard methodology. Days spent at home was calculated as total managed days minus days spent in hospitals or nursing homes. Results: We provided supportive services for 2,388 individuals with IDD in residential waiver services. The population was spread among 12 states and had a mean age of 46.6 (range 13-96). Hospitalization rate was 240 per 1,000 per year. Individuals with IDD spent an average of 360 days per year at home in the community, outside of hospitals and nursing homes. Conclusions: Hospitalization rate and days spent at home are emerging value based outcome measures that may help to align people served, families and stakeholders around the goal of enabling people with IDD to spend more time in the community and less time in hospitals and nursing homes.

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