Healthcare needs of people with intellectual disability in institutions in Taiwan: outpatient care utilization and implications.
Taiwanese adults with ID in institutions visit outpatient clinics twice as often as the general public, mostly for epilepsy and still use pediatric services.
01Research in Context
What this study did
J-Rutherford et al. (2003) asked staff in 14 Taiwanese institutions to record every outpatient visit made by adults with intellectual disability.
They counted visits for one year and noted the reason, clinic type, and basic resident traits like age and epilepsy status.
What they found
Adults with ID averaged 26 outpatient visits each year.
That is double the rate of the general Taiwanese public.
Most trips were to pediatric clinics and were driven by epilepsy, older age, and ease of getting an appointment.
How this fits with other research
K-Alanay et al. (2007) later asked carers in the same settings and found even more illness reports, showing the 2003 count was not a one-off.
Lee et al. (2012) used national insurance files and found children with ID rack up five times the visits, proving heavy use starts early.
Nijs et al. (2016) looked at Norway and saw almost no extra hospital stays for adults with ID.
The Norway and Taiwan numbers seem opposite, but they measure different things: Taiwan counted outpatient clinics, Norway counted overnight stays.
Why it matters
If you serve adults with ID in large facilities, expect lots of clinic trips.
Build epilepsy care and standing appointments into care plans.
Track visit reasons so you can spot treatable patterns early and maybe cut the double-rate load.
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02At a glance
03Original abstract
BACKGROUND: The present study assessed the outpatient care use of people with intellectual disability (ID) in order to identify patterns of healthcare needs and the factors affecting this utilization. METHODS: The primary method used in this study was a cross-sectional survey of 1390 subjects with ID in Taiwan. Data were obtained from questionnaires completed at 30 registered institutions caring for people with ID. RESULTS: The findings show that people with ID in Taiwan are likely to make more outpatient visits per year than members of the general population. The prevalence of illness in people with ID was 41%, with epilepsy being the most frequently reported disease. A total of 39.5% of individuals with ID took medicine regularly, and 38.9% had used alternative forms of medication besides Western medicine. In terms of the use of outpatient facilities by people with ID, paediatric clinics were the most frequently utilized. The average monthly number of outpatient visits per person with ID was 2.18 (around 26 visits per year). This study found that the need for outpatient care is determined by a variety of factors relating to: the age of people with ID, the type of handicap, the place of medical treatment, having a family physician, the accessibility of medical care, the time-consuming nature of the medical visits, having an illness, ID accompanied with other disabilities, and finally, a need for rehabilitative care. CONCLUSIONS: From the examination of the expressed needs of people with ID, it was found that these individuals have a heightened need for healthcare and the treatment of special diseases/disorders in comparison to members of the general population in Taiwan. Within the context of ordinary services, it is particularly important to have a precise view of the ways in which the health needs of people with ID are different from the general population as a whole. This will enable healthcare services to respond to these needs, either through support systems within generic care or, in some cases, through the delivery of specific healthcare through specialized services which are kept separate from generic care.
Journal of intellectual disability research : JIDR, 2003 · doi:10.1046/j.1365-2788.2003.00454.x