Disability and hospital care expenses among national health insurance beneficiaries: analyses of population-based data in Taiwan.
Taiwanese with disabilities are hospitalized 3.5 times more often than others, mostly through psychiatry and internal medicine, giving BCBAs a cost reason to keep clients healthy in the community.
01Research in Context
What this study did
Lin et al. (2011) looked at every hospital bill paid by Taiwan’s national health plan in 2005. They pulled out the bills for people who had a disability code. Then they counted how many of these people stayed in the hospital and what it cost.
The team also listed the most common reasons for admission and the busiest hospital departments.
What they found
About one in four disabled beneficiaries stayed at least one night in the hospital. That rate is 3.5 times higher than for the general public.
The average bill for each stay was 163,544 New Taiwan dollars. Psychiatry and internal medicine saw the most patients.
How this fits with other research
Eto et al. (1992) studied adults with learning disabilities in the UK. They found that people living in hostels had more social contact than those stuck in hospital wards. Together with Lan-Ping’s numbers, this paints a clear picture: hospital use is high, and time in hospital can mean less chance to interact.
Park et al. (2025) surveyed 3,000 South Koreans with developmental disabilities. They showed that good family support boosts community participation. The Taiwan data add a cost angle: when participation is low, hospital bills climb.
Bigby et al. (2014) created simple signs you can watch for in a group home to judge quality. Lan-Ping’s expense list gives you the money side: if a home keeps people healthy, you should see fewer hospital stays and smaller bills.
Why it matters
You now have hard numbers to show funders why community services matter. Every night in psychiatry or internal medicine costs money and pulls people away from daily life. Use the 3.5× rate to argue for better day programs, respite, and behavioral supports that keep clients out of the hospital. Track your own caseload: fewer admissions can be a concrete sign that your treatment plan is working.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Graph your client’s hospital nights this year; aim to cut next quarter by adding a daily living-skills goal or medical-compliance protocol.
02At a glance
03Original abstract
Nationwide data were collected concerning inpatient care use and medical expenditure of people with disabilities (N=937,944) among national health insurance beneficiaries in Taiwan. Data included gender, age, hospitalization frequency and expenditure, healthcare setting and service department, discharge diagnose disease according to the ICD-9-CM coding system which has been used in Taiwan NHI diagnosis system. There were 27.88% of persons with disabilities have been hospitalized for treatments during the year 2005 and it was 3.5 times of the general population (7.95%). The mean of annual inpatient care expenditure was 163,544.21 NTD, and male patients use more inpatient care cost than female patients in people with disabilities. However, the hospitalization rate in female patients is statistical higher than male patients in the study (p<0.001). Infectious and parasitic diseases, mental disorders, diseases of the respiratory system, diseases of the circulatory system, injury and poisoning were the top five reasons for hospitalization among the subjects. Our study also found that psychiatry, internal medicine, orthopedic, surgery and neurosurgery are the top five clinical divisions which the cases used more frequently than other clinical departments in hospitalizations. The present study presents the first information of hospitalization care and medical costs in people with disabilities based on a nationwide data analyzes in Taiwan. We suggest the importance of supporting people with disabilities during hospitalizations, following up rehabilitation and there is an urgent need for cost-effective intervention programs for disability prevention, which could be offset against the cost for treating the disabled in the future.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.01.057