Abstract
BackgroundWe examined the utilization of rehabilitation resources among children with autism spectrum condition (ASC), a neurodevelopmental condition, in Taiwan.MethodsWe derived from the National Health Insurance Research Database of Taiwan data pertaining to 3- to 12-year-old children for the period 2008–2010. Based on diagnoses executed in accordance with the International Classification of Diseases, Ninth Revision, Clinical Modification, we classified these data into the ASC and non-ASC groups and analyzed them through multiple linear regression model, negative binomial model, independent sample t testing, and χ2 testing.ResultsCompared with the non-ASC group, the ASC group exhibited higher utilization of rehabilitation resources. Because hospitals are constrained by overall expenditure limits, expenditure on rehabilitation resources has plateaued, preventing any increase in the utilization of rehabilitation resources. In our ASC group, preschool-aged children significantly outnumbered (p < 0.001) school-aged children. When stratified by the hospital level, district hospitals reported the highest utilization (p < 0.001). When stratified by region, the highest utilization was in Taipei, whereas the lowest was in the East region (p < 0.001). The total annual cost, average frequency of visits, utilization of rehabilitation resources, and average cost were all affected by such elements as patient demographics, hospital type and location (p < 0.001).ConclusionsFor improving treatment outcomes among children with ASC and decreasing treatment expenditure, policies that promote the timely ASC detection and treatment should be implemented.
Highlights
We examined the utilization of rehabilitation resources among children with autism spectrum condition (ASC), a neurodevelopmental condition, in Taiwan
This study revealed that each patient with autism visits hospital outpatient departments 20 times per year; this result is similar to that of another study that revealed that children with ASC had 14.2 physician visits annually [17]
In Taiwan, few studies have examined the utilization of nonpharmacological treatments as rehabilitation resources
Summary
We examined the utilization of rehabilitation resources among children with autism spectrum condition (ASC), a neurodevelopmental condition, in Taiwan. According to a study on disabilities conducted by Taiwan’s Ministry of the Interior in 2010, autism had the fastest growth rate of all disabilities, with an average annual increase of 10.9% since 2009, and the total number of people with autism exceeded 10,000 (Bulletin of the Ministry of the Interior 2011), highlighting that autism spectrum condition (ASC) cannot be ignored. According to the Taiwan’s national health insurance database, the payment of outpatient claims in autism of children and adolescents totaled about 30 millions points in 2000, and it was increased to 130 millions by 2005 [3]. The goal treatment is psychosocial intervention to improve social skills and prosocial behavior with peers which are outpatient rehabilitation services instead of hospital admission treatment. In addition to interventions from physicians (physiatrists, pediatricians, and pediatric psychiatrists) and functional, physical, and speech therapists, clinical psychologists and other therapists are essential to assist patients in achieving greater independence
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