Table 3 The 13 clusters and their descriptions, mean bridging values (B), and importance ratings (I)
Cluster (number of statements) | Description | Ba | Ib |
|---|---|---|---|
1. Awareness and knowledge [11] | Specific awareness about, and knowledge of, the health needs and problems of people with intellectual and developmental disabilities (IDD) is essential in their medical care | 0.12 | 5.4 |
2. Inclusive medical care system [8] | The medical care system has to make reasonable adjustments to accommodate persons with IDD and their specific health needs [25] | 0.16 | 5.4 |
3. Context-sensitive medical care [7] | The organization and funding of medical care for people with IDD differs between and sometimes within countries, for different age groups (children and adults), and compared with the general population | 0.21 | 5.3 |
4. Quality of care [5] | The quality of medical care for people with IDD differs between countries and preventive care is often lacking | 0.21 | 5.1 |
5. Complex diagnostics [3] | People with IDD often cannot verbalize their complaints/symptoms and/or have unidentified conditions, making diagnosis complex | 0.26 | 5.5 |
6. Healthcare disparities [5] | The access, use, and quality of medical care differs between people with IDD and the general population [26]. For example, their needs are not adequately recognized and addressed, they experience communication difficulties, and they are subject to restrictive rules | 0.28 | 4.9 |
7. Skills of, and support for, medical care providers [8] | Medical care providers need specific skills and preconditions (e.g., time, guidelines, tools, resources to facilitate collaboration between sectors) to support the unique health and social considerations of people with IDD | 0.29 | 5.4 |
8. Inequities [8] | People with IDD do not have the same opportunities concerning medical care access, use, and quality compared with the general population. These differences, on for example the socioeconomic, geographic, and racial level, are avoidable [26] | 0.30 | 5.5 |
9. Patient empowerment [4] | People with IDD are fully empowered when they have sufficient knowledge to make rational decisions, sufficient control and resources to implement their decisions, and sufficient experience to evaluate the effectiveness of their decisions concerning their medical care [27] | 0.31 | 5.5 |
10. Coordinated care [5] | Medical care for people with IDD needs to be well-coordinated because many levels of care (providers) are included. This especially concerns horizontal collaboration, such as partnerships and networks within and between sectors and collaboration between health professionals [28] | 0.35 | 5.5 |
11. Medication use [6] | Overmedication is common in the medical care for people with IDD, and people with IDD need to be properly informed about, and consent to, their medication | 0.40 | 5.1 |
12. Medical care communication [4] | People with IDD are often supported by others in their health communication and in making medical care decisions [8] | 0.54 | 5.7 |
13. Attitudinal influences [5] | The medical care use of people with IDD is affected by attitudinal influences: assumptions that discriminate against people with IDD [29]. Because of these attitudinal influences, people with IDD are labelled, stigmatized, and not always adequately protected | 0.69 | 5.0 |