Pre-pandemic and pandemic healthcare utilisation among children with intellectual disabilities compared to the general population: a register study (IDcare)

OBJECTIVES: To investigate utilisation patterns of different types of healthcare in a pre-pandemic and pandemic period, respectively, among children with intellectual disabilities in comparison to their age peers in the general population. STUDY DESIGN: Based on 8 years of register data, we identified 1947 children with intellectual disabilities (ID cohort) and 145 998 children from the general population (gPop cohort). All visits with physicians in outpatient care and all inpatient episodes during a pre-pandemic (2014-2019) and a pandemic (2020-2021) were identified. RESULTS: During both periods, children in the ID cohort were more likely than those in the gPop cohort to have at least one healthcare visit (relative risk 1.06, 95% CI 1.01 to 1.11 during the pre-pandemic period and 1.31, 1.25 to 1.38 during the pandemic period). The largest effects were found for somatic inpatient care, particularly during the pandemic period. The opposite was found for psychiatric specialist care and primary care, where the effect was larger during the pre-pandemic period. Overall, there was a consistent pattern of increased relative rates of utilisation for unplanned care that was less evident for planned care. CONCLUSIONS: Although the results do not indicate any discrimination against children with intellectual disabilities during the COVID-19 pandemic, the results regarding unplanned care highlight the unmet healthcare needs in this group.