Rationale:
Epilepsy affects individuals with intellectual and developmental disabilities (IDD) at higher rates, nevertheless, disparities in inpatient care remain understudied. Contributing factors include diagnostic assessment, fragmented care coordination, and limited access to community-based discharge planning.
Methods: A retrospective cross-sectional analysis using the 2020–2021 National Inpatient Sample (NIS), encompassing 478,476 unweighted discharges (~2.39 million weighted). Patients with epilepsy were stratified by co-occurring IDD using ICD-10 codes (F70–F79 for IDD; G40.x for epilepsy). Outcomes included length of stay, total hospital charges, diagnostic specificity, and discharge disposition. Rao–Scott chi-square tests, multivariable logistic and linear regression models were applied.
Results: Compared to epilepsy patients without IDD, those with IDD were more likely to receive an unspecified epilepsy diagnosis (94.0% vs. 82.3%), experience non-elective admissions (90.8% vs. 88.2%), and be treated in rural hospitals (11.2% vs. 7.1%) (all p < 0.0001). Patients with severe/profound IDD had significantly longer hospital stays and incurred higher charges. Routine discharge to home was more frequent among IDD patients (57.7% vs. 50.8%), although they did not experience elevated rates of institutional placement (42.3% vs. 49.2%).