Disparities in the use of preventive health care among children with disabilities in Taiwan.
Even with free insurance, most kids with disabilities miss basic preventive care—so BCBAs must build it into service plans.
01Research in Context
What this study did
The team looked at Taiwan’s National Health Insurance records for 2004. They counted how many kids with disabilities got preventive care like shots and check-ups. They studied the children years. They asked: who gets care and who misses out?
What they found
Only 38 out of every the kids with disabilities got preventive care. Kids with severe disabilities, low-income families, or living in big cities were the least likely to get care. Even though Taiwan gives everyone free health insurance, most kids still missed out.
How this fits with other research
Chiang et al. (2013) adds more detail. They show the same kids later use hospitals a lot—20 visits a year and triple the cost. Wen-Chen’s low 38 % preventive rate helps explain why these kids end up needing so much urgent care.
Hsu et al. (2009) found that 30 % of these same preschoolers used the ER in just four months. Together the papers paint a clear picture: kids skip cheap prevention and land in expensive crisis care.
Yen et al. (2012) found only 23 % of teens with ID got the flu shot. This matches Wen-Chen’s low preventive rate and shows the problem lasts across ages and services.
Why it matters
If you serve kids with disabilities, check their preventive care records. Schedule the shots and check-ups they missed. Use parent training to explain why prevention beats crisis trips. Track this like any other treatment goal.
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02At a glance
03Original abstract
Children with disabilities face more barriers accessing preventive health services. Prior research has documented disparities in the receipt of these services. However, most are limited to specific types of disability or care. This study investigates disparities in the use of preventive health care among children with disabilities in Taiwan. Three nationwide databases from the Ministry of the Interior, Bureau of Health Promotion, and National Health Research Institutes were linked to gather related information between 2006 and 2008. A total of 8572 children with disabilities aged 1-7 years were included in this study. Multivariate logistic regression analysis was conducted to adjust for covariates. Nationally, only 37.58% of children with disabilities received preventive health care in 2008. Children with severe and very severe disabilities were less likely to use preventive care than those with mild severity. Children with disabilities from the lowest income family were less likely to have preventive care than other income groups. Urbanization was strongly associated with the receipt of preventive health care. However, surprisingly, urban children with disabilities were less likely to receive preventive care than all others. Under universal health insurance coverage, the overall usage of preventive health care is still low among children with disabilities. The study also identified several disparities in their usage. Potential factors affecting the lack of use deserve additional research. Policymakers should target low socioeconomic brackets and foster education about the importance of preventive care. Mobile health services should be continually provided in those areas in need. Capitation reimbursement and other incentives should be considered in improving the utilization among children with disabilities.
Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2011.09.020