Skip to main content
Top
Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Related factors and use of free preventive health services among adults with intellectual disabilities in Taiwan

Authors: Suh-May Yen, Pei-Tseng Kung, Li-Ting Chiu, Wen-Chen Tsai

Published in: BMC Health Services Research | Issue 1/2014

Login to get access

Abstract

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.
Literature
1.
go back to reference Maulik PK, Mascarenhas MN, Mathers CD, Dua T, Saxena S: Prevalence of intellectual disability: a meta-analysis of population-based studies. Res Dev Disabil. 2011, 32 (2): 419-436. 10.1016/j.ridd.2010.12.018.PubMedCrossRef Maulik PK, Mascarenhas MN, Mathers CD, Dua T, Saxena S: Prevalence of intellectual disability: a meta-analysis of population-based studies. Res Dev Disabil. 2011, 32 (2): 419-436. 10.1016/j.ridd.2010.12.018.PubMedCrossRef
3.
go back to reference Wang YT: Are adults with intellectual disabilities socially excluded? An exploratory study in Taiwan. J Intellect Disabil Res. 2013, 57 (10): 893-902. 10.1111/j.1365-2788.2012.01574.x.PubMedCrossRef Wang YT: Are adults with intellectual disabilities socially excluded? An exploratory study in Taiwan. J Intellect Disabil Res. 2013, 57 (10): 893-902. 10.1111/j.1365-2788.2012.01574.x.PubMedCrossRef
4.
go back to reference Durvasula S, Beange H, Baker W: Mortality of people with intellectual disability in northern Sydney. J Intellect Dev Disabil. 2002, 27 (4): 255-264. 10.1080/1366825021000029311.CrossRef Durvasula S, Beange H, Baker W: Mortality of people with intellectual disability in northern Sydney. J Intellect Dev Disabil. 2002, 27 (4): 255-264. 10.1080/1366825021000029311.CrossRef
5.
go back to reference Patja K, Iivanainen M, Vesala H, Oksanen H, Ruoppila I: Life expectancy of people with intellectual disability: a 35-year follow-up study. J Intellect Disabil Res. 2000, 44 (Pt 5): 591-599.PubMedCrossRef Patja K, Iivanainen M, Vesala H, Oksanen H, Ruoppila I: Life expectancy of people with intellectual disability: a 35-year follow-up study. J Intellect Disabil Res. 2000, 44 (Pt 5): 591-599.PubMedCrossRef
6.
go back to reference Tyrer F, McGrother C: Cause-specific mortality and death certificate reporting in adults with moderate to profound intellectual disability. J Intellect Disabil Res. 2009, 53 (11): 898-904. 10.1111/j.1365-2788.2009.01201.x.PubMedCrossRef Tyrer F, McGrother C: Cause-specific mortality and death certificate reporting in adults with moderate to profound intellectual disability. J Intellect Disabil Res. 2009, 53 (11): 898-904. 10.1111/j.1365-2788.2009.01201.x.PubMedCrossRef
7.
go back to reference van Schrojenstein Lantman-De HM, Metsemakers JF, Haveman MJ, Crebolder HF: Health problems in people with intellectual disability in general practice: a comparative study. Fam Pract. 2000, 17 (5): 405-407. 10.1093/fampra/17.5.405.CrossRef van Schrojenstein Lantman-De HM, Metsemakers JF, Haveman MJ, Crebolder HF: Health problems in people with intellectual disability in general practice: a comparative study. Fam Pract. 2000, 17 (5): 405-407. 10.1093/fampra/17.5.405.CrossRef
8.
go back to reference Kwok H, Cheung PWH: Co-morbidity of psychiatric disorder and medical illness in people with intellectual disabilities. Curr Opin Psychiatry. 2007, 20 (5): 443-449. 10.1097/YCO.0b013e3282ab9941.PubMedCrossRef Kwok H, Cheung PWH: Co-morbidity of psychiatric disorder and medical illness in people with intellectual disabilities. Curr Opin Psychiatry. 2007, 20 (5): 443-449. 10.1097/YCO.0b013e3282ab9941.PubMedCrossRef
9.
go back to reference Lin JD, Yen CF, Loh CH, Hsu SW, Huang HC, Tang CC, Li CW, Wu JL: A cross-sectional study of the characteristics and determinants of emergency care utilization among people with intellectual disabilities in Taiwan. Res Dev Disabil. 2006, 27 (6): 657-667. 10.1016/j.ridd.2005.09.001.PubMedCrossRef Lin JD, Yen CF, Loh CH, Hsu SW, Huang HC, Tang CC, Li CW, Wu JL: A cross-sectional study of the characteristics and determinants of emergency care utilization among people with intellectual disabilities in Taiwan. Res Dev Disabil. 2006, 27 (6): 657-667. 10.1016/j.ridd.2005.09.001.PubMedCrossRef
10.
go back to reference Rimmer JH, Yamaki K, Lowry BMD, Wang E, Vogel LC: Obesity and obesity-related secondary conditions in adolescents with intellectual/developmental disabilities. J Intellect Disabil Res. 2010, 54 (9): 787-794. 10.1111/j.1365-2788.2010.01305.x.PubMedCrossRef Rimmer JH, Yamaki K, Lowry BMD, Wang E, Vogel LC: Obesity and obesity-related secondary conditions in adolescents with intellectual/developmental disabilities. J Intellect Disabil Res. 2010, 54 (9): 787-794. 10.1111/j.1365-2788.2010.01305.x.PubMedCrossRef
11.
go back to reference Sohler N, Lubetkin E, Levy J, Soghomonian C, Rimmerman A: Factors associated with obesity and coronary heart disease in people with intellectual disabilities. Soc Work Health Care. 2009, 48 (1): 76-89. 10.1080/00981380802451160.PubMedCrossRef Sohler N, Lubetkin E, Levy J, Soghomonian C, Rimmerman A: Factors associated with obesity and coronary heart disease in people with intellectual disabilities. Soc Work Health Care. 2009, 48 (1): 76-89. 10.1080/00981380802451160.PubMedCrossRef
12.
go back to reference Diab ME, Johnston MV: Relationships between level of disability and receipt of preventive health services. Arch Phys Med Rehabil. 2004, 85 (5): 749-757. 10.1016/j.apmr.2003.06.028.PubMedCrossRef Diab ME, Johnston MV: Relationships between level of disability and receipt of preventive health services. Arch Phys Med Rehabil. 2004, 85 (5): 749-757. 10.1016/j.apmr.2003.06.028.PubMedCrossRef
13.
go back to reference Lin JD, Yen CF, Wu JL: Importance and satisfaction of preventive health strategies in institutions for people with intellectual disabilities: a perspective of institutional directors. Res Dev Disabil. 2005, 26 (3): 267-280. 10.1016/j.ridd.2004.11.001.PubMedCrossRef Lin JD, Yen CF, Wu JL: Importance and satisfaction of preventive health strategies in institutions for people with intellectual disabilities: a perspective of institutional directors. Res Dev Disabil. 2005, 26 (3): 267-280. 10.1016/j.ridd.2004.11.001.PubMedCrossRef
14.
go back to reference Weng RH, Kung PT, Tsai WC, Chiang HH, Chiu LT: The use of fluoride varnish and its determining factors among children with disability in Taiwan. Res Dev Disabil. 2011, 32 (2): 583-592. 10.1016/j.ridd.2010.12.016.PubMedCrossRef Weng RH, Kung PT, Tsai WC, Chiang HH, Chiu LT: The use of fluoride varnish and its determining factors among children with disability in Taiwan. Res Dev Disabil. 2011, 32 (2): 583-592. 10.1016/j.ridd.2010.12.016.PubMedCrossRef
15.
go back to reference Iezzoni LI, McCarthy EP, Davis RB, Harris-David L, O'Day B: Use of screening and preventive services among women with disabilities. Am J Med Qual. 2001, 16 (4): 135-144. 10.1177/106286060101600405.PubMedCrossRef Iezzoni LI, McCarthy EP, Davis RB, Harris-David L, O'Day B: Use of screening and preventive services among women with disabilities. Am J Med Qual. 2001, 16 (4): 135-144. 10.1177/106286060101600405.PubMedCrossRef
16.
go back to reference Phillips KA, Mayer ML, Aday LA: Barriers to care among racial/ethnic groups under managed care. Health Aff. 2000, 19 (4): 65-75. 10.1377/hlthaff.19.4.65.CrossRef Phillips KA, Mayer ML, Aday LA: Barriers to care among racial/ethnic groups under managed care. Health Aff. 2000, 19 (4): 65-75. 10.1377/hlthaff.19.4.65.CrossRef
17.
go back to reference Ramirez A, Farmer GC, Grant D, Papachristou T: Disability and preventive cancer screening: results from the 2001 California Health Interview Survey. Am J Public Health. 2005, 95 (11): 2057-2064. 10.2105/AJPH.2005.066118.PubMedPubMedCentralCrossRef Ramirez A, Farmer GC, Grant D, Papachristou T: Disability and preventive cancer screening: results from the 2001 California Health Interview Survey. Am J Public Health. 2005, 95 (11): 2057-2064. 10.2105/AJPH.2005.066118.PubMedPubMedCentralCrossRef
18.
go back to reference Shabas D, Weinreb H: Preventive healthcare in women with multiple sclerosis. J Womens Health Gend Based Med. 2000, 9 (4): 389-395. 10.1089/15246090050020709.PubMedCrossRef Shabas D, Weinreb H: Preventive healthcare in women with multiple sclerosis. J Womens Health Gend Based Med. 2000, 9 (4): 389-395. 10.1089/15246090050020709.PubMedCrossRef
19.
go back to reference Pearson V, Davis C, Ruoff C, Dyer J: Only one quarter of women with learning disability in Exeter have cervical screening. BMJ (Clinical Research Ed). 1998, 316 (7149): 1979.CrossRef Pearson V, Davis C, Ruoff C, Dyer J: Only one quarter of women with learning disability in Exeter have cervical screening. BMJ (Clinical Research Ed). 1998, 316 (7149): 1979.CrossRef
20.
go back to reference Perry J, Kerr M, Felce D, Bartley S, Tomlinson J: Monitoring the public health impact of health checks for adults with a learning disability in Wales: Final report of the Public Health Wales/WCLD project group. 2010, Cardiff: Public Health Wales & Welsh Centre for Learning Disabilities Perry J, Kerr M, Felce D, Bartley S, Tomlinson J: Monitoring the public health impact of health checks for adults with a learning disability in Wales: Final report of the Public Health Wales/WCLD project group. 2010, Cardiff: Public Health Wales & Welsh Centre for Learning Disabilities
21.
go back to reference Lennox N, Bain C, Rey-Conde T, Purdie D, Bush R, Pandeya N: Effects of a comprehensive health assessment programme for Australian adults with intellectual disability: a cluster randomized trial. Int J Epidemiol. 2007, 36 (1): 139-146. 10.1093/ije/dyl254.PubMedCrossRef Lennox N, Bain C, Rey-Conde T, Purdie D, Bush R, Pandeya N: Effects of a comprehensive health assessment programme for Australian adults with intellectual disability: a cluster randomized trial. Int J Epidemiol. 2007, 36 (1): 139-146. 10.1093/ije/dyl254.PubMedCrossRef
22.
go back to reference Maciosek MV, Coffield AB, Flottemesch TJ, Edwards NM, Solberg LI: Greater use of preventive services in U.S. health care could save lives at little or no cost. Health Aff. 2010, 29 (9): 1656-1660. 10.1377/hlthaff.2008.0701.CrossRef Maciosek MV, Coffield AB, Flottemesch TJ, Edwards NM, Solberg LI: Greater use of preventive services in U.S. health care could save lives at little or no cost. Health Aff. 2010, 29 (9): 1656-1660. 10.1377/hlthaff.2008.0701.CrossRef
23.
go back to reference Gandjour A: Aging diseases–do they prevent preventive health care from saving costs?. Health Econ. 2009, 18 (3): 355-362. 10.1002/hec.1370.PubMedCrossRef Gandjour A: Aging diseases–do they prevent preventive health care from saving costs?. Health Econ. 2009, 18 (3): 355-362. 10.1002/hec.1370.PubMedCrossRef
24.
go back to reference Macnab AJ, Rozmus J, Benton D, Gagnon FA: 3-year results of a collaborative school-based oral health program in a remote First Nations community. Rural Remote Health. 2008, 8 (2): 882.PubMed Macnab AJ, Rozmus J, Benton D, Gagnon FA: 3-year results of a collaborative school-based oral health program in a remote First Nations community. Rural Remote Health. 2008, 8 (2): 882.PubMed
25.
go back to reference Malach M, Baumol WJ: Opportunities for the cost reduction of medical care. J Community Health. 2009, 34 (4): 255-261. 10.1007/s10900-009-9155-7.PubMedCrossRef Malach M, Baumol WJ: Opportunities for the cost reduction of medical care. J Community Health. 2009, 34 (4): 255-261. 10.1007/s10900-009-9155-7.PubMedCrossRef
26.
go back to reference Rodriguez Vazquez C, Garcillan R, Rioboo R, Bratos E: Prevalence of dental caries in an adult population with mental disabilities in Spain. Spec Care Dentist. 2002, 22 (2): 65-69. 10.1111/j.1754-4505.2002.tb01164.x.PubMedCrossRef Rodriguez Vazquez C, Garcillan R, Rioboo R, Bratos E: Prevalence of dental caries in an adult population with mental disabilities in Spain. Spec Care Dentist. 2002, 22 (2): 65-69. 10.1111/j.1754-4505.2002.tb01164.x.PubMedCrossRef
27.
go back to reference Kung PT, Tsai WC, Li YH: Determining factors for utilization of preventive health services among adults with disabilities in Taiwan. Res Dev Disabil. 2012, 33 (1): 205-213. 10.1016/j.ridd.2011.09.006.PubMedCrossRef Kung PT, Tsai WC, Li YH: Determining factors for utilization of preventive health services among adults with disabilities in Taiwan. Res Dev Disabil. 2012, 33 (1): 205-213. 10.1016/j.ridd.2011.09.006.PubMedCrossRef
28.
go back to reference Huang KH, Tsai WC, Kung PT: The use of Pap smear and its influencing factors among women with disabilities in Taiwan. Res Dev Disabil. 2012, 33 (2): 307-314. 10.1016/j.ridd.2011.09.016.PubMedCrossRef Huang KH, Tsai WC, Kung PT: The use of Pap smear and its influencing factors among women with disabilities in Taiwan. Res Dev Disabil. 2012, 33 (2): 307-314. 10.1016/j.ridd.2011.09.016.PubMedCrossRef
30.
go back to reference Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA: Gender differences in the utilization of health care services. J Fam Pract. 2000, 49 (2): 147-152.PubMed Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA: Gender differences in the utilization of health care services. J Fam Pract. 2000, 49 (2): 147-152.PubMed
31.
go back to reference Green CA, Pope CR: Gender, psychosocial factors and the use of medical services: a longitudinal analysis. Soc Sci Med. 1999, 48 (10): 1363-1372. 10.1016/S0277-9536(98)00440-7.PubMedCrossRef Green CA, Pope CR: Gender, psychosocial factors and the use of medical services: a longitudinal analysis. Soc Sci Med. 1999, 48 (10): 1363-1372. 10.1016/S0277-9536(98)00440-7.PubMedCrossRef
32.
go back to reference Owens GM: Gender differences in health care expenditures, resource utilization, and quality of care. J Manag Care Pharm. 2008, 14 (3 Suppl): 2-6.PubMed Owens GM: Gender differences in health care expenditures, resource utilization, and quality of care. J Manag Care Pharm. 2008, 14 (3 Suppl): 2-6.PubMed
33.
go back to reference Haveman M, Perry J, Salvador-Carulla L, Walsh PN, Kerr M, Van Schrojenstein Lantman-de Valk H, Van Hove G, Berger DM, Azema B, Buono S, Cara AC, Germanavicius A, Linehan C, Ma¨a¨tta¨ T, Tossebro J, Weber G: Ageing and health status in adults with intellectual disabilities: results of the European POMONA II study. J Intellect Dev Disabil. 2011, 36 (1): 49-60. 10.3109/13668250.2010.549464.PubMedCrossRef Haveman M, Perry J, Salvador-Carulla L, Walsh PN, Kerr M, Van Schrojenstein Lantman-de Valk H, Van Hove G, Berger DM, Azema B, Buono S, Cara AC, Germanavicius A, Linehan C, Ma¨a¨tta¨ T, Tossebro J, Weber G: Ageing and health status in adults with intellectual disabilities: results of the European POMONA II study. J Intellect Dev Disabil. 2011, 36 (1): 49-60. 10.3109/13668250.2010.549464.PubMedCrossRef
34.
go back to reference Hewitt M, Devesa SS, Breen N: Cervical cancer screening among U.S. women: analyses of the 2000 National Health Interview Survey. Prev Med. 2004, 39 (2): 270-278. 10.1016/j.ypmed.2004.03.035.PubMedCrossRef Hewitt M, Devesa SS, Breen N: Cervical cancer screening among U.S. women: analyses of the 2000 National Health Interview Survey. Prev Med. 2004, 39 (2): 270-278. 10.1016/j.ypmed.2004.03.035.PubMedCrossRef
35.
go back to reference Katz SJ, Hofer TP: Socioeconomic disparities in preventive care persist despite universal coverage: breast and cervical cancer screening in Ontario and the United States. JAMA. 1994, 272 (7): 530-534. 10.1001/jama.1994.03520070050037.PubMedCrossRef Katz SJ, Hofer TP: Socioeconomic disparities in preventive care persist despite universal coverage: breast and cervical cancer screening in Ontario and the United States. JAMA. 1994, 272 (7): 530-534. 10.1001/jama.1994.03520070050037.PubMedCrossRef
36.
go back to reference Rodriguez MA, Ward LM, Perez-Stable EJ: Breast and cervical cancer screening: impact of health insurance status, ethnicity, and nativity of Latinas. Ann Fam Med. 2005, 3 (3): 235-241. 10.1370/afm.291.PubMedPubMedCentralCrossRef Rodriguez MA, Ward LM, Perez-Stable EJ: Breast and cervical cancer screening: impact of health insurance status, ethnicity, and nativity of Latinas. Ann Fam Med. 2005, 3 (3): 235-241. 10.1370/afm.291.PubMedPubMedCentralCrossRef
37.
go back to reference Kung PT, Tsai WC, Chiou SJ: The assessment of the likelihood of mammography usage with relevant factors among women with disabilities. Res Dev Disabil. 2012, 33 (1): 136-143. 10.1016/j.ridd.2011.08.032.PubMedCrossRef Kung PT, Tsai WC, Chiou SJ: The assessment of the likelihood of mammography usage with relevant factors among women with disabilities. Res Dev Disabil. 2012, 33 (1): 136-143. 10.1016/j.ridd.2011.08.032.PubMedCrossRef
Metadata
Title
Related factors and use of free preventive health services among adults with intellectual disabilities in Taiwan
Authors
Suh-May Yen
Pei-Tseng Kung
Li-Ting Chiu
Wen-Chen Tsai
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-248

Other articles of this Issue 1/2014

BMC Health Services Research 1/2014 Go to the issue