Prevalence healthcare and rehabilitation services utilization in individuals with cerebral palsy

  • 張 明瑞

Student thesis: Doctoral Thesis


Cerebral palsy (CP) is the most common cause of motor disability in children The information of prevalence of CP is essential in order to plan medical educational and social services to children and their family With advanced medical care the majority of children with CP can survive into adulthood With lifelong disability people with CP have complex health issues and rely heavily on the healthcare system It is important to recognize the healthcare needs and plan age-appropriate intervention programs However little is known about healthcare service used by people with CP across the lifespan The importance of rehabilitation therapy service for children with CP is widely understood The consequences of disability can be reduced through well-coordinated rehabilitation therapy (physical therapy PT; occupational therapy OT; and speech and language pathology SLP) services However little is known about the service utilization patterns of individuals with CP and the factors associated with rehabilitation therapy service use Therefore this dissertation includes three studies on the individuals with CP aimed to investigate the prevalence healthcare and rehabilitation therapy service utilization of individuals with CP in Taiwan The first study estimated the prevalence of CP using different case definitions from the representative sample of one million patients covered by Taiwan’s National Health Insurance (NHI) The estimated prevalence of CP (cases per 1000 live births) varied from 4 1 to 1 3 for different case definitions The older the minimum age at diagnosis and the stricter the case definition used the smaller was the estimated prevalence of CP Using a case definition compatible with those used in most other studies the estimated prevalence of CP in Taiwan is higher than in other countries Additional studies are needed to determine the reasons of higher prevalence The second study examined the utilization patterns of people with CP across lifespan in Taiwan Data for this study was obtained from the NHI Research Database (NHIRD) sample dataset registry of beneficiaries Participants with pediatrician- or physical and rehabilitative medicine physician-diagnosed CP recorded in Taiwan’s NHI claims database were recruited CP cases included in this study were followed-up until the end of 2003 Annual rates of outpatient physician visits were 31 680 for children 16 492 for youth and 28 617 for adults with CP (per 1000 persons) Patients received over half of their outpatient care from hospitals More children than youth and adults used specialist physician services Respiratory diseases were the primary reason for visits by children and youth; circulatory diseases were the primary reason for adults The third study examined the pattern of rehabilitation therapy service use of individuals with CP and identified factors associated with use Data for this study was obtained from the one-million sample set of registry of beneficiaries from NHIRD Cases were identified by the presence of the International Classification of Disease Clinical Modification ninth revision (ICD-9-CM) code 343 from 1997 to 2000 Individuals included in this study were followed up until the end of 2004 Logistic regression was used to analyze the factors related to utilization of rehabilitation therapy service In addition ANOVA was used to analyze the factors correlated to the frequency of rehabilitation therapy service among the CP cases Among 1178 participants over 40% received at least one rehabilitation therapy (PT OT SLP) services during 2000-2004 Age copayment status and comorbidity were associated with rehabilitation therapy service utilization The mean annual rehabilitation therapy visits were different among age group copayment status and comorbidity Additional studies are needed to identify the severity and other factors which related to the use of rehabilitation therapy service of individuals with CP
Date of Award2017 Feb 2
Original languageEnglish
SupervisorHui-Ing Ma (Supervisor)

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