Chang Yu-Chia, Lin Jin-Ding, Tung Ho-Jui, Chiang Po-Huang, Hsu Shang-Wei
Department of Healthcare Administration, Asia University, Taichung, Taiwan; Research Center of Health Policy and Management, Asia University, Taichung, Taiwan.
School of Public Health, National Defense Medical Center, Taipei, Taiwan.
Res Dev Disabil. 2014 Feb;35(2):498-505. doi: 10.1016/j.ridd.2013.12.001. Epub 2013 Dec 25.
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.
本研究分析了台湾智障儿童和青少年门诊物理治疗(PT)的利用情况及其利用的决定因素。开展了一项横断面研究,以分析来自35802名18岁及以下智障人士的2007年国民健康保险(NHI)理赔数据。共有3944名(11.02%)理赔者接受了门诊物理治疗。影响物理治疗利用的变量包括年龄、居住地区城市化水平、智障程度、自付费用状况和主要合并症。每年的物理治疗平均就诊次数为25.4±33.0;学龄前儿童、患有重大疾病的理赔者以及智障合并脑瘫的患者每次就诊的平均费用更高。年龄、智障程度、自付费用状况和合并症是影响支出的因素。学龄前儿童、男性、居住在城市化水平最低地区的人以及患有重大疾病的人倾向于使用医院服务。癫痫和脑瘫的时点患病率分别为12.10%和19.80%。尽管国民健康保险计划和政府有规定提供特殊服务,但智障儿童和青少年的物理治疗利用率较低,且利用率随着受试者年龄的增长而下降。