Caregivers' perceptions of accessibility, satisfaction and policy priorities of health care for people with intellectual disabilities in Taiwan

Background: The caregiver is the vital facilitator for the health care of people with intellectual disabilities. However, there is a lack of literature on the perceptions of caregivers about health care issues for people with intellectual disabilities. The aim of this study was to examine the accessibility, satisfaction, and priorities of health care for people with intellectual disabilities based on the perceptions of caregivers in Taiwan. Methods: A cross-sectional study was employed and subjects were recruited from the Taiwan National Disability Registration System. A final sample of 1,071 persons, registered as having intellectual disabilities in 2001, was recruited for the study. Data were collected via a questionnaire that was mailed to and completed by the caregivers of these subjects. Results: Thirty-eight percent of caregivers reported that they felt inconvenienced or very inconvenienced concerning the accessibility of health care provision for persons with intellectual disabilities. Fifty percent of respondents reported that the Taiwan National Health Insurance (NHI) did not adequately meet the requirements of people with intellectual disabilities. Among the respondents, 37.8% were dissatisfied or very dissatisfied with the Taiwan NHI scheme for people with intellectual disabilities. Caregivers' dissatisfaction with the NHI was twice that of the general population. Analysis of weighted scores showed the top five health care issues were: "support regular health checkups for people with intellectual disabilities" (importance=38.35); "out-of-pocket medical fee auxiliary" (importance=31. 58); "access to health information" (importance=18.03); "concession of medical consultation fee" (importance=16.84); and "subsidy of health insurance premium" (importance= 15.19). Conclusions: For successful health care policy development, the health care system in Taiwan should be reoriented to strengthen accessibility, availability, and affordability to meet the health needs of people with intellectual disabilities.