台湾成年智障者的相关因素及免费预防保健服务的使用情况
Related factors and use of free preventive health services among adults with intellectual disabilities in Taiwan.
作者信息
Yen Suh-May, Kung Pei-Tseng, Chiu Li-Ting, Tsai Wen-Chen
机构信息
Department of Health Services Administration, China Medical University, No, 91 Hsueh-Shih Road, Taichung 40402, Taiwan.
出版信息
BMC Health Serv Res. 2014 Jun 12;14:248. doi: 10.1186/1472-6963-14-248.
BACKGROUND
This study aimed to investigate the utilization of preventive health services in the adults with intellectual disabilities from the nationwide database.
METHODS
The research method of this study is secondary data analysis. The data was obtained from three nationwide databases from 2006 to 2008. This study employed descriptive statistics to analyze the use and rate of preventive health services by intellectual disabled adults. Chi-square test was used to determine the relationship between the utilization of preventive health services and these variables. Multivariate logistic regression analysis was used to explore the factors that affect intellectual disabled adults' use of preventive health services.
RESULTS
Our findings indicated 16.65% of people with intellectual disabilities aged over 40 years used the preventive health services. Females were more frequent users than males (18.27% vs. 15.21%, p <0.001). The utilization rate decreased with increasing severity of intellectual disabilities. The utilization was lowest (13.83%) for those with very severe disability, whereas that was the highest (19.38%) for those with mild severity. The factors significantly influencing utilization of the services included gender, age, and marital status, urbanization of resident areas, monthly payroll, low-income household status, catastrophic illnesses status and relevant chronic diseases and severity of disability.
CONCLUSIONS
Although Taiwan's Health Promotion Administration (HPA) has provided free preventive health services for more than 15 years, people with intellectual disabilities using preventive health care tend to be low. Demographics, economic conditions, health status, relevant chronic diseases, environmental factor, and severity of disability are the main factors influencing the use of preventive healthcare. According to the present findings, it is recommended that the government should increase the reimbursement of the medical staff performing health examinations for the persons with intellectual disabilities. It is also suggested to conduct media publicity and education to the public and the nursing facilities for the utilization of adult preventive health services.
背景
本研究旨在利用全国性数据库调查成年智障人士预防性健康服务的利用情况。
方法
本研究采用二次数据分析的研究方法。数据取自2006年至2008年的三个全国性数据库。本研究采用描述性统计分析智障成年人士预防性健康服务的使用情况和使用率。采用卡方检验确定预防性健康服务利用情况与这些变量之间的关系。采用多因素逻辑回归分析探讨影响智障成年人士预防性健康服务利用的因素。
结果
我们的研究结果表明，40岁以上的智障人士中有16.65%使用了预防性健康服务。女性的使用率高于男性（18.27%对15.21%，p<0.001）。随着智障严重程度的增加，使用率下降。重度智障者的使用率最低（13.83%），而轻度智障者的使用率最高（19.38%）。显著影响服务利用的因素包括性别、年龄、婚姻状况、居住地区的城市化程度、月工资、低收入家庭状况、重大疾病状况、相关慢性病以及残疾严重程度。
结论
尽管台湾地区健康促进管理部门（HPA）提供免费预防性健康服务已超过15年，但智障人士预防性医疗保健的利用率仍然较低。人口统计学、经济状况、健康状况、相关慢性病、环境因素以及残疾严重程度是影响预防性医疗保健利用的主要因素。根据目前的研究结果，建议政府增加对为智障人士进行健康检查的医务人员的补贴。还建议针对成年预防性健康服务的利用情况对公众和护理机构进行媒体宣传和教育。
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