Department of Child & Adolescent Psychiatry, Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.
Institute of Health Care Management, Department of Business Management, National Sun Yat-Sen University, Kaohsiung City, Taiwan.
PLoS One. 2018 Jun 28;13(6):e0199877. doi: 10.1371/journal.pone.0199877. eCollection 2018.
Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder in children. This study investigated the use of rehabilitation treatment in Taiwan. We selected children aged 3-12 years from the National Health Insurance Research Database from 2008 to 2012 and included them in the analysis. The children who received a diagnosis according to the International Classification of Diseases, Ninth Revision, Clinical Modification were divided into two groups: ADHD and non-ADHD. We used the chi-squared test, independent sample t test, and multiple regression analysis to conduct the analysis. The utilisation of rehabilitation resources was higher in the ADHD group than in the non-ADHD group. The number of school-aged children with ADHD was higher than the number of preschool-aged children (p < 0.001). The highest utilisation of rehabilitation resources was observed in clinics (p < 0.001). In terms of region, Taipei exhibited the highest utilisation of rehabilitation resources, and the East exhibited the lowest resource utilisation (p < 0.001). Prediction of the use of rehabilitation resources, average cost, average frequency of visits, and total annual cost was affected by factors such as the average frequency of rehabilitation use, demographic characteristics, and the hospital characteristics and location (p < 0.001). The number of children with ADHD and rehabilitation use are increasing yearly; however, limitations in payment restrict the growth of rehabilitation resource use in hospitals. Supplementation of rehabilitation resources at clinics accounts for more than 60%, however, the total annual cost is less than what is observed for hospitals (p < 0.001). Policies should be established to aid in the early detection and treatment of children with ADHD to improve treatment outcomes and reduce the family burden and treatment expenditure in the future.
注意缺陷多动障碍（ADHD）是一种儿童神经发育障碍。本研究调查了台湾康复治疗的应用。我们从 2008 年至 2012 年的国家健康保险研究数据库中选择了 3-12 岁的儿童，并将其纳入分析。根据国际疾病分类，第九修订版，临床修正进行诊断的儿童被分为两组：ADHD 和非 ADHD。我们使用卡方检验、独立样本 t 检验和多元回归分析进行分析。ADHD 组的康复资源利用率高于非 ADHD 组。学龄儿童 ADHD 人数高于学龄前儿童（p < 0.001）。康复资源利用率最高的是诊所（p < 0.001）。在地区方面，台北的康复资源利用率最高，东部的利用率最低（p < 0.001）。康复资源利用率、平均费用、平均就诊频率和年总费用的预测受到康复使用频率、人口统计学特征、医院特征和位置等因素的影响（p < 0.001）。ADHD 儿童和康复使用率逐年增加；然而，支付限制限制了医院康复资源使用的增长。诊所的康复资源补充占比超过 60%，但年总费用低于医院（p < 0.001）。应制定政策，帮助早期发现和治疗 ADHD 儿童，以改善治疗结果，并减轻未来家庭负担和治疗支出。
