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Provider Quality Improves the Personal Outcomes of People with IDD

By Carli Friedman, CQL Director of Research

A person’s quality of life is impacted by many things, ranging from their individual attributes to organizational, environmental, and systemic factors. The services and supports people with intellectual and developmental disabilities (IDD) receive can either improve or hinder their quality of life. For example, through our research, we’ve found the type of setting a person with IDD lives in significantly impacts their personal outcomes.

While it is established that organizational factors affect people’s quality of life, no research has directly explored how the quality of human service providers impacts people with IDD’s personal outcomes. For these reasons, the aim of this study conducted by CQL | The Council on Quality and Leadership was to examine the relationship between human service provider quality and the quality of life – personal outcomes – of people with IDD. To do so, we analyzed Basic Assurances® data about provider quality and Personal Outcome Measures® data about people with IDD’s personal outcomes. The data came from 2,900 people with IDD supported by 331 different human service providers. (We controlled for: age; communication method; decision-making authority; gender; race; complex support needs; residence type; provider size; provider geographic region; and, provider service options.)

We found that the better the quality of their human service provider, the better quality of life people with IDD had, regardless of their or their providers’ demographics (see figure below). For example, controlling for all demographics, a person with IDD supported by a provider that had 40 Basic Assurances® indicators present (out of a possible 92) had 8.8 personal outcomes present (out of a possible 21). In contrast, a person with IDD supported by a provider that had 80 Basic Assurances® indicators present had 12.3 personal outcomes present.

The Impact of Provider Quality on Personal Outcomes

As provider quality (basic assurances) increases, the number of personal outcomes of people with IDD increases. For every one Basic Assurance indicator present, the number of outcomes increases by 0.07. The graph follows a linear pattern.

“People with IDD face a number of disparities in quality of life compared to other populations, largely due to systemic inequities and social determinants of health. In this study we found people with IDD who were served by higher quality providers had significantly more personal outcomes present, regardless of their demographics or complex support needs. While quality improvement initiatives may require a significant investment of both time and financial resources from providers, our findings suggest the efforts translate to improved personal outcomes among people with IDD. The quality of life of people with IDD demands quality person-centered services and supports. The ultimate goal of service providers should be improvement of quality of life among those they support” (Friedman, 2021).

This article is a summary of the following journal manuscript: Friedman, C. (2022). The impact of human service provider quality on the personal outcomes of people with intellectual and developmental disabilities. Frontiers in Rehabilitation Sciences, 2, 780168.