Healthcare needs of people with intellectual disability in institutions in Taiwan: outpatient care utilization and implications.

BACKGROUND The present study assessed the outpatient care use of people with intellectual disability (ID) in order to identify patterns of healthcare needs and the factors affecting this utilization. METHODS The primary method used in this study was a cross-sectional survey of 1390 subjects with ID in Taiwan. Data were obtained from questionnaires completed at 30 registered institutions caring for people with ID. RESULTS The findings show that people with ID in Taiwan are likely to make more outpatient visits per year than members of the general population. The prevalence of illness in people with ID was 41%, with epilepsy being the most frequently reported disease. A total of 39.5% of individuals with ID took medicine regularly, and 38.9% had used alternative forms of medication besides Western medicine. In terms of the use of outpatient facilities by people with ID, paediatric clinics were the most frequently utilized. The average monthly number of outpatient visits per person with ID was 2.18 (around 26 visits per year). This study found that the need for outpatient care is determined by a variety of factors relating to: the age of people with ID, the type of handicap, the place of medical treatment, having a family physician, the accessibility of medical care, the time-consuming nature of the medical visits, having an illness, ID accompanied with other disabilities, and finally, a need for rehabilitative care. CONCLUSIONS From the examination of the expressed needs of people with ID, it was found that these individuals have a heightened need for healthcare and the treatment of special diseases/disorders in comparison to members of the general population in Taiwan. Within the context of ordinary services, it is particularly important to have a precise view of the ways in which the health needs of people with ID are different from the general population as a whole. This will enable healthcare services to respond to these needs, either through support systems within generic care or, in some cases, through the delivery of specific healthcare through specialized services which are kept separate from generic care.

[1]  R. Andersen.  Health status indices and access to medical care. , 1978, American journal of public health.

[2]  R. Andersen,et al.  A framework for the study of access to medical care. , 1974, Health services research.

[3]  F. Dunstan,et al.  Attitudes of general practitioners towards health care for people with intellectual disability and the factors underlying these attitudes. , 1997, Journal of intellectual disability research : JIDR.

[4]  Rubin Il.  Health care needs of adults with mental retardation. , 1987 .

[5]  C. Tyler,et al.  Primary care of adults with mental retardation. , 1997, The Journal of family practice.

[6]  E. N. Herberg,et al.  Medical needs of children in institutions for the mentally retarded. , 1969, American journal of public health and the nation's health.

[7]  J. Rabkin.  Mental Health Needs Assessment: A Review of Methods , 1986, Medical care.

[8]  M. Haveman,et al.  Prevalence and incidence of health problems in people with intellectual disability. , 2007, Journal of intellectual disability research : JIDR.

[9]  M. Kerr,et al.  A randomized control trial of an opportunistic health screening tool in primary care for people with intellectual disability. , 1997, Journal of intellectual disability research : JIDR.

[10]  P. Minihan.  Planning for community physician services prior to deinstitutionalization of mentally retarded persons. , 1986, American journal of public health.

[11]  K. Strassburger,et al.  Provision of health care for persons with developmental disabilities living in the community. The Morristown model. , 1988, JAMA.

[12]  A. McElduff,et al.  Medical disorders of adults with mental retardation: a population study. , 1995, American journal of mental retardation : AJMR.

[13]  D. Felce,et al.  Primary Health Care for People with a Learning Disability , 1996 .

[14]  J. Wilkinson,et al.  Development and importance of health needs assessment , 1998, BMJ.

[15]  H. Beange.  Caring for a vulnerable population , 1996 .

[16]  A. Jobling.  Beyond sex and cooking: health education for individuals with intellectual disability. , 2001, Mental retardation.

[17]  J. Polder,et al.  Demographic and epidemiological determinants of healthcare costs in Netherlands: cost of illness study , 1998, BMJ.

[18]  M. Haveman,et al.  People with intellectual disability in general practice: case definition and case finding. , 1997, Journal of intellectual disability research : JIDR.