Determining factors for utilization of preventive health services among adults with disabilities in Taiwan.
Free preventive care is not free if clients never walk in—add behavior supports.
01Research in Context
What this study did
Kung et al. (2012) looked at every disabled adult in Taiwan who was offered free preventive health checks.
They counted how many showed up and asked: who skips and why?
What they found
Only 16 out of every 100 adults used the free service.
Men and people with severe disabilities were the least likely to go.
How this fits with other research
Huang et al. (2012) saw the same pattern for Pap smears: only 8% of disabled women went.
Lai et al. (2014) repeated the check for dental cleanings and again found only 16% uptake.
All three studies point to the same groups—males, severe disability, low income—missing free care.
Why it matters
If free is not enough, BCBAs must add extra steps. Schedule the appointment, send reminders, arrange transport, and teach the client what to expect. Target males and severe cases first; they are the hardest to reach.
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02At a glance
03Original abstract
Taiwan has provided free health checks for adults since 1995. However, very little previous research has explored the use of preventive health services by physically and mentally disabled adults. The present study aimed to understand this use of preventive health services and the factors that influence it. Research participants included disabled people registered in a Ministry of the Interior database in 2008 (a total of 785,746 adults who met the conditions for being physically or mentally disabled and using preventive health services). These data were merged with the Bureau of Health Promotion's 2006-2008 dataset on preventive health and the 2006-2008 health insurance database published by the National Health Research Institutes. In addition to descriptive and bivariate analysis, the study used logistic regression analysis to investigate the factors that influence the use of adult preventive health services. The results showed that 15.81% of physically and mentally disabled adults used preventive health services. The rate of use among females was significantly higher than the rate among males, and rates were higher among residents of relatively less urbanized areas. Usage rates were also universally higher among sufferers of chronic diseases. However, more serious disabilities had lower usage rates. From the logistic regression analysis, we ascertained that the factors that influenced the use of preventive health services were gender, age, level of urbanization, monthly salary, low-income household status, aboriginal status, catastrophic disease/injury status, chronic diseases, type of disability, and severity of the disability. The study's main conclusion is that although Taiwan's Department of Health has provided free preventive health services for more than 15 years, the usage rate of this care among the disabled remains low. Demographic features, health status, and type of disability are the main factors influencing the use of preventive healthcare services.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2011.09.006