Current Services and Outcomes of Formerly Institutionalised and Never-institutionalised US Adults with Intellectual and Developmental Disabilities: A Propensity Score Matching Analysis


Background: Deinstitutionalization research shows better services and outcomes relative to institutional life but has not compared formerly institutionalised and never-institutionalised service users.

Methods: We used propensity score matching (PSM) to match formerly institutionalised and never-institutionalised participants on six personal characteristics. Data came from the 2018 to 2019 National Core Indicators In-Person Survey. We excluded current institution residents, and states with 25% + of missing data on former institutionalisation.

Results: Overall, 15.5% of participants in the 29-state full sample had lived in an institution for 1 year or more. Findings from the PSM sample showed that former-institution residents were more likely to use congregate living arrangements and less likely to live with family. They experienced more loneliness, less support-related choice, and had a consistent pattern of disability service-focused social connections.

Conclusions: Many former institution residents remain disadvantaged relative to matched peers. There is a need to identify factors to enhance services and outcomes following deinstitutionalization.

Suggested Citation

Stancliffe, R. J., Tichá, R., Pettingell, S. L., Houseworth, J., & Bershadsky, J. (2023). Current services and outcomes of formerly institutionalised and never‐institutionalised US adults with intellectual and developmental disabilities: A propensity score matching analysis. Journal of Applied Research in Intellectual Disabilities.


Peer-Reviewed Article 
British Institute of Learning Disabilities


  • Community life
    • Community supports and services
  • Housing and residential services
    • Institutions and deinstitutionalization
  • Specific disability
    • Intellectual/developmental disability (IDD)