Service Delivery

Outpatient physical therapy utilization for children and adolescents with intellectual disabilities in Taiwan: a population-based nationwide study.

Chang et al. (2014) · Research in developmental disabilities 2014
★ The Verdict

Even with free national insurance, only 1 in 9 Taiwanese youth with ID get outpatient PT and numbers fall with age.

✓ Read this if BCBAs who write therapy referrals for school or clinic.
✗ Skip if Practitioners outside insurance-based health systems.

01Research in Context

01

What this study did

Chang et al. (2014) looked at every child and teen with intellectual disability in Taiwan.

They counted how many used outpatient physical therapy in one year under the national health plan.

02

What they found

Only 11 out of every 100 kids with ID got PT.

Use dropped as kids got older, even though insurance paid for it.

03

How this fits with other research

Chiang et al. (2013) saw the same kids rack up 20 doctor visits a year, triple the usual rate.

High overall care but low PT looks like a puzzle.

Lai et al. (2014) later showed women with ID also miss cancer screens at just 4%.

Together the papers paint one picture: Taiwan’s system covers everything, yet specific rehab and preventive services stay under-used.

04

Why it matters

If you serve kids with ID, don’t assume “insured” means “reached.”

Add PT checks to your care plan each birthday and teach families how to book it.

A quick referral script can push the rate above 11%.

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Add a PT referral tick-box to your annual review form for every client with ID.

02At a glance

Intervention
not applicable
Design
other
Sample size
35802
Population
intellectual disability
Finding
negative

03Original abstract

This study analyzed the utilization and utilization determinants of outpatient physical therapy (PT) among children and adolescents with intellectual disabilities (ID) in Taiwan. A cross-sectional study was conducted to analyze 2007 national health insurance (NHI) claim data from 35,802 eighteen-year-old and younger persons with intellectual disabilities. A total of 3944 (11.02%) claimants received outpatient physical therapy. Variables that affected PT utilization included age, residence urbanization level, ID level, copayment status and major co-morbidity. The average annual PT visit frequency was 25.4 ± 33.0; pre-school children, claimants suffering from catastrophic disease and ID co-occurring with cerebral palsy had a higher mean cost per visit. Age, ID level, copayment status and co-morbidity were factors that influenced expenditure. Pre-school children, males, individuals who resided in the lowest urbanization areas and individuals with a catastrophic disease tended to use hospital services. The point prevalence of epilepsy and cerebral palsy were 12.10% and 19.80%, respectively. Despite the NHI program and government regulations to provide special services, the use of physical therapy for children and adolescents with intellectual disabilities was low, and the utilization decreased as the subjects aged.

Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2013.12.001