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Dementia care resources in Taiwan have not been allocated taking into account patients' needs and the distance between service users and providers. The objective of this study was to use two newly developed indicators; profit willing distance (PWD) and tolerance limited distance (TLD), to profile the service availability and accessibility of the 22 administrative areas in Taiwan and facilitate justice-based resource allocation by the central government. The study employed secondary data analysis by using a geographic information system (GIS) and geocoding to identify distances between service users and providers. The study samples were drawn from the databank of the National Disability Eligibility Determination System and grouped by the acuteness of registrants' needs. Both the PWD and TLD were found in 15 of the administrative areas, and neither was found in three areas (Penghu, Kinmen, and Lienchiang County). Either the PWD or TLD (but not both) were found in four areas (only have PWD: Hsinchu and Chiayi City; only have TLD: Yunlin and Taitung County). How the priorities should be set for dementia service allocation based on these findings was also addressed. We conclude that the indicators of PWD and TLD can add value to the policy decision-making process, help set priorities, and facilitate efficient and fair resource allocation by defining specifics of the resources needed.

Background  Obesity and the health problems associated with it have substantial economic consequences for health care systems. Little information is available concerning obesity‐related problems among people with intellectual disabilities. The aims of this study were to analyse patterns of obesity among children and adolescents with intellectual disabilities in Taiwan and to compare these data with existing national norms in an attempt to identify the scale of the problem of obesity among this population.Methods  Information was collected by postal questionnaire on a total of 279 children and adolescents with intellectual disabilities (age 4–18 years).Results  Sixty‐four per cent of participants in the study had multiple disabilities and 40% had additional health needs. In terms of general health status, most of the persons with intellectual disabilities were reported to be in fair or good health, with 9% of them being reported to be unhealthy or very unhealthy. Body mass index (BMI) was related to age, but not to gender, morbidity or prescribed medication at the time of the survey. However, average BMI was higher than relevant population norms reported in Taiwan's Third National Nutrition and Health Survey (1993–1996). The overall prevalence of obesity was 18%, with 14% of participants aged 4–6 years, 22% of participants aged 7–12 years and 16% of participants aged 13–18 years being obese. In a multiple regression analysis of BMI, age was the only significant predictor of obesity, accounting for 8% of variation.Conclusions  The findings suggest that the problem of obesity among children and adolescents with intellectual disabilities should be considered a major public health concern that warrants further attention in health care systems.

Purpose To explore the physical activity level of community environmental volunteering (CEV) participants and the differences in physical functions and daily activity patterns between the older adults who engaged in intensive CEV (≥15 hours/week) and non-intensive CEV (<15 hours/week) groups. Design Cross-sectional study. Setting Three recycling stations in Taiwan. Sample In total, 113 community-dwelling older adults who regularly participated in CEV. The response rate was 53%. Measures The ActiGraph wGT3x-BT accelerometer for the percentage of sedentary, light, and moderate to vigorous physical activity (MVPA) of CEV time and awaken time; the Jamar hand dynamometer for grip strength; and the MicroFET3 muscle testing dynamometer for knee extension strength. Analysis Analysis of covariance with the baseline characteristics as covariates. Results Overall, MVPA, light, and sedentary activities accounted for 53.73%, 41.10%, and 5.23% of CEV time, respectively. The intensive group (n = 61) displayed greater dominant handgrip strength ( P = .004) and higher MVPA percentage in daily life ( P = .044) than the non-intensive group (n = 52). Conclusion CEV provides sufficient opportunities for older adults to perform physical activity. Intensive CEV is related to greater handgrip strength but not lower limb strength. Further study is needed to establish the causal relationship between CEV and health variates.

Abstract  Health planning is an important factor in assuring quality of care for the general population. However, in Taiwan relatively little attention has been given to this with respect to vulnerable groups of people, such as those with intellectual disabilities (ID). Using a structured questionnaire, posted to all disability service programs (n = 157) caring for people with ID, the authors examined the perceptions of directors of service programs for people with ID with respect to health planning and the development of health‐planning issues in their programs. Results indicate that although most respondents agreed with the importance of health planning and concurred with the specific health‐planning issues identified by the authors, there was a gap between perceived importance and satisfaction with how these issues were being dealt. The three greatest gaps were observed in "hearing and vision screenings,""routine meetings on health issues," and "regular dental health checkups for the ID population." Using an opportunity calculation to prioritize the most promising health‐planning areas, the authors found that "emergency planning and practice,""routine meetings on health management,""planning for infectious disease control,""regular oral health checkups," and "hearing and vision screenings" were the areas with greatest opportunities for further improvement in the programs. Size and auspice of the programs were not correlated to the perceived importance and satisfactions. The authors conclude that Taiwanese health authorities need to more carefully promote health planning for people with ID within disability programs so as to ensure the quality of health care and health promotion for people with ID.

Aims  The aims of the present study were to explore the perceptions of general practitioners (GPs) in the provision of health care services for people with intellectual disabilities and to analyse GPs' priorities in the delivery of health care services to this group of people in Taiwan.Methods  The study employed a cross‐sectional design and was conducted by a census method, the aim being to collect information from all GPs in Taiwan. A questionnaire was mailed out, between 10 April 2006 and 16 June 2006, and the responses provided by 331 GPs (response rate = 16) were included in the analysis.Results  The results showed that most of the respondents did not have sufficient experience to deal with patients with intellectual disabilities and lacked adequate knowledge about intellectual disabilities. Indeed, respondents expressed the need for on‐the‐job training in the field of intellectual disabilities and generally agreed that their role in providing health care services for people with intellectual disabilities was important. However, they were generally not satisfied with the achievements of their role on health care issues. The study highlighted that many issues need to be prioritized for people with intellectual disabilities in relation to policy planning at different health care stages (primary, secondary and tertiary health care). The results also revealed that those senior GPs with considerable experience in treating people with intellectual disabilities were more likely satisfied with their role in providing health care for this group of people.Conclusions  It is concluded that Taiwanese health and welfare authorities need to focus more carefully on issues concerning deficiencies in the training of GPs, and to employ appropriate strategies to address health care issues raised in the present study so as to improve the quality of care for people with intellectual disabilities.

The aim of this study was to explore the association between employment status and World Health Organization Disability Assessment Schedule, Second Edition (WHODAS 2.0) scores of working-age subjects with hearing impairment. The data of 18,573 working-age subjects (age ≥ 18 and <65 years) with disabling hearing impairment were obtained from the Taiwan Data Bank of Persons with Disability (TDPD) for the period from 11 July 2012 to 31 October 2018. Demographic data and WHODAS 2.0 scores for each domain were analyzed to identify their relationship with employment status. Unemployed subjects with disabling hearing impairment had higher WHODAS 2.0 scores in all domains compared with the employed subjects. Binary logistic regression revealed that older age, female sex, lower educational level, institutional residence, rural residence, lower family income, and moderate to severe impairment were more strongly associated with unemployment status. The data in this large population-based study offer comprehensive information on important factors associated with the employment status of people with disabling hearing impairment. Early identification of risks of unemployment of patients with hearing impairment can raise awareness for aggressive community and government campaigns regarding public health to improve the self-confidence, social participation, and related psycho-social wellbeing of people.

Background  In encouraging good health for people with intellectual disabilities, health promotion serves as an effective intervention. However, little is known about health promotion strategies for this sector of the population. The objectives of this study were to describe the current profile of health promotion planning among institutions caring for people with intellectual disabilities in Taiwan, and to examine differences among institutions.Method  The study employed a cross‐sectional survey of 157 directors of institutions caring for people with intellectual disabilities in Taiwan. A structured questionnaire was posted to obtain information relating to the planning, budget appropriations, and decision‐making processes concerning health promotion at these institutions.Results  A total of 120 directors of institutions completed the posted questionnaire. Health promotion plans were operative at 88.4% of the institutions. Among these institutions, 82 settings (76.6%) set aside funding on an annual basis for health promotion programmes for people with intellectual disabilities. With regard to budget spending, most of the respondents did not know exactly what percentage of the annual budget was spent on the health promotion programmes operating in their institutions. The process of health promotion implementation was multidisciplinary and intersectoral in terms of the staff involved. Those institutions that employed skilled nurses were more likely to run health promotion programmes than those institutions without nursing staff.Conclusions  Further research should be focused on the efficacy of health promotion programmes for people with intellectual disabilities, and on the creation of supportive environments in institutions for enabling these people to participate in the process of decision‐making on health promotion issues.