Department of Health Services Administration, China Medical University, Taichung, Taiwan, ROC.
Res Dev Disabil. 2012 Mar-Apr;33(2):324-33. doi: 10.1016/j.ridd.2011.09.020. Epub 2011 Nov 26.
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.
残疾儿童在获得预防保健服务方面面临更多障碍。先前的研究记录了这些服务在获得方面的差异。然而，大多数研究仅限于特定类型的残疾或护理。本研究调查了台湾残疾儿童在使用预防保健方面的差异。内政部、健康促进局和国家健康研究所的三个全国性数据库被联系起来，以收集 2006 年至 2008 年之间的相关信息。共有 8572 名 1-7 岁的残疾儿童纳入本研究。采用多变量逻辑回归分析调整协变量。全国范围内，2008 年只有 37.58%的残疾儿童接受了预防保健。严重和极严重残疾的儿童比轻度残疾的儿童更不可能使用预防护理。来自最低收入家庭的残疾儿童比其他收入群体更不可能接受预防保健。城市化与预防保健的获得密切相关。然而，令人惊讶的是，城市残疾儿童接受预防保健的比例低于其他所有儿童。在全民健康保险覆盖下，残疾儿童整体预防保健的使用率仍然较低。该研究还确定了他们使用方面的一些差异。影响缺乏使用的潜在因素值得进一步研究。政策制定者应针对社会经济地位较低的人群，并加强关于预防保健重要性的教育。应在有需要的地区持续提供移动医疗服务。应考虑人头付费报销和其他激励措施，以提高残疾儿童的利用率。
