COMPARATIVE MORTALITY OF PEOPLE WITH MENTAL-RETARDATION IN INSTITUTIONS AND THE COMMUNITY

The role of institutions has come into question in recent decades, and the size of the institutionalized population has been drastically red uced. Risk-adjusted mortality rates in institutions and the community in California from 1980 through 1992 were compared, with the aim of im proving our understanding of the capacity of the community health syst em to support deinstitutionalization. Risk-adjusted odds on mortality were estimated to be 72% higher in the community than in institutions. Some problems with health care delivery in the community were reviewe d; these may help account for the difference. Consumers and guardians should weigh these considerations when making choices between institut ional versus community-based care.