title: Outpatient physical therapy utilization for children and adolescents with intellectual disabilities in Taiwan: a population-based nationwide study.
abstract: 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.
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan; Research Center of Health Policy and Management, Asia University, Taichung, Taiwan.
authors.forename: Yu-Chia
authors.initials: YC
authors.lastname: Chang
authors.affiliation: School of Public Health, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Jin-Ding
authors.initials: JD
authors.lastname: Lin
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan; Research Center of Health Policy and Management, Asia University, Taichung, Taiwan.
authors.forename: Ho-Jui
authors.initials: HJ
authors.lastname: Tung
authors.affiliation: Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Po-Huang
authors.initials: PH
authors.lastname: Chiang
authors.affiliation: Department of Healthcare Administration, Asia University, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan. Electronic address: victor_h@asia.edu.tw.
authors.forename: Shang-Wei
authors.initials: SW
authors.lastname: Hsu
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data*; D002547:Cerebral Palsy / Q000453:epidemiology / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000453:epidemiology; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000534:rehabilitation*; D016015:Logistic Models; D008297:Male; D009313:National Health Programs / Q000191:economics; D026741:Physical Therapy Modalities / Q000191:economics / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data
keywords: Children and adolescents; Intellectual disability; Outpatient; Physical therapy; Rehabilitation