Utilization of inpatient care and its determinants among persons with intellectual disabilities in day care centres in Taiwan.
Taiwanese adults with ID who have several handicaps or illnesses are the ones most often hospitalized.
01Research in Context
What this study did
Thomas et al. (2004) asked one clear question. Which adults with intellectual disability in Taiwan day-care centres end up in hospital?
They mailed surveys to every day-centre in Taiwan. Staff filled in health data for 1,390 attendees.
What they found
Sixteen percent had stayed at least one night in hospital during the past year.
The biggest red flags were younger age, several handicaps, need for rehab, and other illnesses.
How this fits with other research
Lin et al. (2006) ran the same survey style and found almost the same share—18 percent—used emergency care, not inpatient wards. The two papers line up like matching puzzle pieces.
Dagnan et al. (2005) added a new layer. People with ID plus a psychiatric disorder used even more inpatient, outpatient, and emergency care. The 2004 data hinted at this; the 2005 paper proved it.
Chiang et al. (2013) later checked every child with ID in Taiwan’s national database. Kids averaged 20 outpatient visits a year and triple the medical cost of peers. The day-centre snapshot from 2004 was only the tip of the high-use iceberg.
Why it matters
If you serve adults with ID, treat multiple diagnoses and rehab needs as hospital-risk flags. Build care plans that catch illness early, teach families when to call nurses first, and track medication effects. These steps can keep clients out of hospital beds and in your program.
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02At a glance
03Original abstract
BACKGROUND: In Taiwan, current understanding is limited concerning the manner in which health services are utilized by persons with intellectual disabilities (ID). The objective of this study is to describe the patterns of inpatient care sought by persons with ID, and factors affecting inpatient care utilization. METHOD: The primary method used in this study was a cross-sectional survey of 1390 persons with ID in day care centres. Data were obtained from responses to a questionnaire, copies of which were mailed to 30 day care centres catering for persons with ID. The questionnaire assessed demographic and health characteristics, disability status, and inpatient care utilization for the 12 months leading up to the survey. Multivariate logistic regression analysis identified factors independently associated with inpatient care. RESULTS: Findings indicated that the average age of the people with ID in the centres was 13.7 years. Fifty per cent of people were afflicted with multiple handicaps, with an average of 26 outpatient visits made per person during the 12 months, and 16% of persons having been hospitalized within the previous year. The average hospital stay was 6 days. Inpatient care was more likely to be used by those individuals with an ID who were younger, had multiple handicaps, required rehabilitation, and had other disabilities and existing illnesses. CONCLUSIONS: The study concluded that the parameters describing age of persons with ID, as having an existing illness, and requiring rehabilitative care were statistically significant in the logistic regression model of the inpatient care.
Journal of intellectual disability research : JIDR, 2004 · doi:10.1111/j.1365-2788.2003.00572.x