Healthcare utilization and expenditure analysis between individuals with intellectual disabilities and the general population in Taiwan: a population-based nationwide child and adolescent study.
Taiwanese youth with ID average 20 outpatient visits and triple the medical costs of peers—plan for high rehabilitative and psychiatric service demand.
01Research in Context
What this study did
Chiang et al. (2013) looked at every child and teen with ID in Taiwan. They used the national health insurance records. They counted doctor visits, hospital stays, and money spent.
They compared these kids to same-age kids without ID. The study covered one full year.
What they found
Kids with ID had 20 doctor visits a year. Other kids had 11. Costs were three times higher.
Most extra visits were for rehab and psychiatry. One in five kids with ID saw a psychiatrist.
How this fits with other research
Tsai et al. (2012) seems to disagree. They say only a large share of kids with disabilities get preventive care. The key difference is the lens. Wen-Chen looked at check-ups and shots only. Po-Huang counted every visit, including therapy.
Hsu et al. (2009) backs the high-use story. In Taipei, a large share of preschoolers with disabilities went to the ER in just four months. Fever and breathing trouble drove the trips.
Yen et al. (2012) adds another gap. Only a large share of teens with ID got the flu shot. High overall use does not mean every need is met.
Why it matters
If you serve a child with ID, expect heavy medical traffic. Budget for rehab and psychiatry. At intake, ask about ER trips and missed shots. Link families to preventive care even when total visits look high.
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02At a glance
03Original abstract
This study examines differences in outpatient-visit frequency and medical expenditures between (1) children and adolescents in Taiwan with intellectual disabilities and (2) children and adolescents in Taiwan's general population. A cross-sectional study was conducted to analyze data from 2007 provided by Taiwan's National Health Insurance program. A total of 236,045 beneficiaries younger than 19 years made use of outpatient services; among them, 35,802 had a principal diagnosis of mental retardation (intellectual disability). The average number of ambulatory visits was 14.9 ± 12.4, which is much higher than in the United States and other developed countries. The mean number of annual visits of the individuals with intellectual disabilities was significantly higher than that of the general population in Taiwan (20.1 ± 20.0 vs. 14.0 ± 12.2); age, gender, urbanization level of residential area, and copayment status affected outpatient visit frequency. The mean annual outpatient costs were NTD6371.3 ± NTD11989.1 for the general population and NTD19724.9 ± NTD40469.9 for those with intellectual disabilities (US $1 equals approximately NTD30). Age, gender, urbanization level of residential area, and copayment status were the determinants that accounted for this difference in cost. Children and adolescents with intellectual disabilities had higher use rates of rehabilitative and psychiatric services than the general population. We conclude that individuals with intellectual disabilities had higher demands than the general population for healthcare services, especially for rehabilitative and psychiatric services.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.05.026