Longitudinal analyses of geographic differences in utilization rates of children with developmental delays who participation in early intervention services.

The purposes of the present study were to describe the longitudinal utilization rates of participation in early intervention services of children with developmental delays, and to examine the geographical difference of services in this vulnerable population. We analyzed service utilization of the developmentally delayed children based on data of governmental reported early intervention services from year 2003 to 2009 in Taiwan. Results show that, the utilization rate of early intervention services was 9.18‰ (range=6.96-12.09‰) of children in 0-5 years during the past 7 years. Mean utilization rate in age group of 0-2 years was 8.32‰ (range=5.73-10.93‰), and age group of 3-5 years was 9.92‰ (range=7.78-13.78‰). We found that the utilization rate in all children aged 0-5 years (R(2)=0.93; p<0.001), boy group (R(2)=0.93; p<0.001) and girl group (R(2)=0.92; p=0.001) were significant increased gradually. The higher utilization rate of early intervention services (aged 0-5 years) were more likely to locate in the north cities (Keelung City=14.65‰; Taipei City=13.49‰), east areas--Hualien County (14.03‰), Taitung County (11.76‰) and central or south counties such as, Chiayi City (14.05‰), Tainan City (12.47‰), and Miaoli County (12.38‰). Hsinchu County (5.97‰), Kaohsiung City (6.21‰), Taichung County (6.74‰), Taipei County (6.95‰) have lower utilization rates of early intervention in Taiwan. The study highlights that the health care system should close the gaps in geographic disparities of early intervention services for children with developmental delays, and respond timely to the needs of these vulnerable children and their families.