It has been estimated that approximately 1.8% of the Australian population have an intellectual disability.1 An intellectual disability can be described as a cognitive impairment that becomes apparent during a person’s early developmental period and diversely impacts adaptive functioning.2 People with intellectual disability have poor health outcomes with two times the rate of emergency department hospital admissions, higher rates of physical and mental conditions, low levels of preventive healthcare and two times the rate of avoidable deaths compared with the general population.3–5 Some poor health outcomes can be associated with complex physical and mental health comorbidities.6–8 However, recent evidence from the Royal Commission into the Violence, Abuse, Neglect and Exploitation of people with Disability exposed that many health inequalities are in fact driven by systematic neglect of the healthcare system.9

In response to the findings of the Disability Royal Commission, the Australian Federal Government launched the ‘Roadmap for Improving the Health of people with Intellectual disability’. The Roadmap sets out a vision for health system reform in order to meet the healthcare needs of people with intellectual disability through providing high-quality healthcare that supports health throughout the entirety of their lives.5 Since the launch of the Roadmap, work to improve healthcare for people with intellectual disability has increased significantly. The implementation of the Primary Care Enhancement Program for people with intellectual disability, improving the implementation of annual health assessments, curriculum development in intellectual disability health and the launch of the National Centre of Excellence in Intellectual Disability and Health are all ways in which Australia is improving healthcare for people with intellectual disability.10 Factors such as poor health professional knowledge and attitudes surrounding intellectual disability,11 communication barriers between the person with intellectual disability, carers and health professionals12–15 and lack of implementation of reasonable adjustments16–18 are some of the challenges known to be faced by people with intellectual disability. These barriers to healthcare are present for people with intellectual disability of all ages experiencing both physical and mental health conditions.13 19–21 Ultimately, affecting the overall quality of healthcare that people with intellectual disability are receiving.

Quality healthcare can be defined as the degree to which health services are achieving desired health outcomes.22 In Australia, the quality of health services is protected by the National Safety and Quality Health Service Standards.23 The Australian Health Performance Framework (AHPF) presents a framework for monitoring health and healthcare in Australia. The AHPF describes quality health services as being effective, safe, appropriate, providing continuity of care as well as being accessible, efficient and sustainable.24

To address health inequalities in Australia, we need to have a clearer picture of the existing evidence relating to the quality of healthcare across primary, secondary and tertiary healthcare settings for people with intellectual disability. The current review will map the existing evidence relating to healthcare quality for people with intellectual disability. Academic literature from English-speaking, developed countries with similar health systems (universal healthcare coverage, funded primarily through general taxation) will also be included to broaden and contextualise the evidence. These universal health systems are typically financed through income taxes and other general government revenues, assisting to provide access to health services for all residents without causing financial hardship. The evidence will be visually mapped using figures and tables across the dimensions described in the AHPF (effectiveness, safety, appropriateness, continuity of care, accessibility and efficiency/sustainability). The AHPF holds value in the Australian healthcare policy landscape and is a useful framework to underpin and define quality healthcare.24 Evidence will also be mapped across other areas of interest such as age groups, healthcare setting/types, healthcare transitions, specific population groups (First Nations, culturally and linguistically diverse and LGBTQI+) and geography. This will provide a visual overview of the breadth of the existing literature relating to quality healthcare of people with intellectual disability. This review will ultimately assist in directing future investments such as research and capacity building in the field, with the overarching goal to improve health services for people with intellectual disability.

The current review aims to: (1) map the existing evidence for quality healthcare in Australia and similar health systems to broad definitions of quality healthcare dimensions from the AHPF (effectiveness, safety, appropriateness, continuity of care, accessibility, efficiency/sustainability) for people with an intellectual disability; (2) map the existing evidence of healthcare quality for people with intellectual disability more broadly, in order to understand gaps in the evidence base and where future investments should be targeted; (3) identify gaps in the evidence to inform priority recommendations in healthcare and healthcare policy for people with intellectual disability.

For the academic literature, abstract screening will be undertaken using Covidence software. All identified studies will be screened on their title and abstract by two reviewers. A study inclusion/exclusion criterion will be applied to all titles and abstracts to ensure standardisation of the process; this can be found in online supplemental appendix B. Any queries will be resolved through discussion between the two reviewers.

Patients or the public were not involved in the design, or conduct, or reporting, or dissemination plans of our research.

Ethics approval is not required for this type of research.

Table 1 describes the anticipated publications that will be produced from this research protocol.

Not applicable.