Comparison of outpatient services between elderly people with intellectual disabilities and the general elderly population in Taiwan.
Elderly clients with IDD rack up 17% more outpatient visits, so budget extra time and money for medical appointments.
01Research in Context
What this study did
Hsu et al. (2012) looked at Taiwan's national insurance records. They compared every clinic visit made by elderly people with intellectual disabilities to visits by same-age neighbors without disabilities.
The team counted how many times each person saw a doctor in one year. They also added up the money paid for those visits.
What they found
Clients with IDD averaged 35 clinic visits per year. Their peers without disabilities averaged 30.
The extra visits raised yearly costs for the IDD group. More appointments means more travel, more co-pays, and more care coordination for families.
How this fits with other research
Hung et al. (2011) used the same Taiwan database. They found that adults with Down syndrome stay in the hospital three times longer and pay triple the inpatient cost. Shang-Wei et al. now show the pattern continues outside the hospital.
Storch et al. (2012) reviewed global studies on aging with IDD. Their summary warned that pain, falls, and hospice barriers drive up visits. The Taiwan numbers match that picture.
Lee et al. (2022) showed that older adults with IDD who skip dental check-ups lose more teeth. Taken together, the papers say one thing: adults with IDD need steady, proactive care across every specialty.
Why it matters
When you write a care plan, expect about one extra clinic trip every two months. Build this into caregiver training, transportation budgets, and prior-authorization requests. Schedule quarterly reviews so small problems are caught early, before they turn into the costly hospital stays Wen-Jiu et al. flagged.
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02At a glance
03Original abstract
This study aims to analyze the ambulatory visit frequency and medical expenditures of the general elderly population versus the elderly with intellectual disabilities in Taiwan, while examining the effects of age, gender, urbanization and copayment status on ambulatory utilization. A cross-sectional study was conducted to analyze data from 103,183 national health insurance claimants aged 65 or older. A total of 1469 had a principal diagnosis of mental retardation (intellectual disability) and claimed medical outpatient services in 2007. The average number of ambulatory visits was 30.1 ± 23.1, which is much higher than in the United States and other developed countries, and the mean annual visits of the elderly with intellectual disabilities was significantly higher than the general population in Taiwan (35.2 ± 28.7 vs. 30.0 ± 23.1). Age and copayment status affected outpatient visit frequency. The mean medical expenditure per visit and the mean annual outpatient cost were 1146.5 ± 4497.7 NT$ and 34,533.7 ± 115,891.7 NT$, respectively. Male beneficiaries tended to have higher average annual medical expenses and mean medical expenses per visit than female beneficiaries. The three most frequent principal diagnoses at ambulatory visits were circulatory system diseases, musculoskeletal system and connective tissue diseases and digestive system diseases. We conclude that the elderly with intellectual disabilities had higher demand than the general population for healthcare services, and the NHI program lowers the barrier to care for populations with special needs.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2012.03.014