A cross-sectional study of the characteristics and determinants of emergency care utilization among people with intellectual disabilities in Taiwan.
One in five Taiwanese adults with ID visited the ER in seven months, and daily meds plus poor health were the clearest predictors.
01Research in Context
What this study did
Lin et al. (2006) asked a simple question. How often do adults with intellectual disability in Taiwan need the ER?
They mailed surveys to 1,071 people with ID. They asked about ER trips in the past seven months. They also asked about health, meds, and doctor visits.
What they found
Eighteen out of every 100 people had gone to the ER. That is almost one in five.
The biggest red flags were poor health, current illness, and taking daily medicine. If a person had all three, ER risk jumped.
How this fits with other research
Dagnan et al. (2005) looked at the same Taiwanese ID group one year earlier. They found twelve out of 100 had a mental-health diagnosis and used more of every service, including the ER. The new study zooms in on ER use only.
Chiang et al. (2013) moved the lens to kids. Taiwanese youth with ID averaged 20 outpatient visits a year and triple the medical cost of peers. High use starts young and continues into adulthood.
Hsu et al. (2009) studied preschoolers with any disability in Taipei. Thirty out of 100 visited the ER in just four months. Fever and breathing problems topped the list. The adult ID numbers look lower, but the time frames differ.
Why it matters
If you support adults with ID, treat daily meds and chronic illness as ER warning lights. Schedule monthly nurse check-ins. Teach staff to spot early breathing issues or fever. A quick clinic visit can head off a midnight ER run.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a weekly vital-sign check for clients who take daily meds and log any fever or breathing change.
02At a glance
03Original abstract
AIMS: The purpose of this study was to identify health characteristics of people with intellectual disabilities (ID) and to assess the use of emergency care facilities by these people and factors affecting this utilization. METHOD: A cross-sectional study was employed. Subjects were recruited from the Taiwan National Disability Registration System. A total of 1071 people registered with ID in Taiwan were recruited for this study in 2001. Data were collected via a structured mail-out questionnaire that was completed by the main carers of people with ID. RESULTS: Most of the carers subjectively characterized the overall health status of people with ID as good-excellent. However, people with ID carry a burden of diseases greater than that of the general population. Nearly half (47.7%) of the subjects reported having an illness in the past 7 months. Most of the morbidity was associated with neurological, psychiatric, digestive, dermatological and cardiovascular diseases or disorders. One-third of subjects took medication regularly and 15% were 'Major Illness' card beneficiaries of the Taiwan National Health Insurance scheme. About two-thirds of individuals with ID were classified as having multiple disabilities and 24.5% needed to be provided with frequent rehabilitative therapies to maintain their normal daily functions. Respondents indicated that 18.4% of the subjects had used emergency care in the past 7 months. A stepwise logistic regression model highlighted that the following need factors were significantly related to the utilization of emergency care: having an illness (OR=2.1, 95% CI=1.2-3.6), taking medicine regularly (OR=1.8, 95% CI=1.1-2.9) and self-reported health status (poor health: OR=9.9, 95% CI=2.1-45.7; bad health: OR=8.2, 95% CI=1.3-49.8). CONCLUSIONS: To ensure that people with ID minimize their utilization of emergency care, it is necessary to establish in appropriate community systems to monitor individuals with ID with poor health status, diseases and who take medicine regularly.
Research in developmental disabilities, 2006 · doi:10.1016/j.ridd.2005.09.001