| Abstract: | Intellectual disabilities are a type of lifelong disabilities. Patients' mental handicap will cause the insufficiencies of their cognition and self-care ability, resulting in being in vulnerable position in society. Also, due to the innate health disparity, they bring a huge burden to their families, the society and the entire health care system. Gastroesophageal reflux disease (GERD) is clinically a disease often seen in patients with Intellectual disabilities, but its severity is usually underestimated. Factors inducing the disease include scoliosis, cerebral palsy, and taking anti-epileptic drugs or sedatives like benzodiazepines. If not treated, GERD will probably lead to serious complications, such as asthma, chronic cough, lung fibrosis and esophageal adenocarcinoma. This research used the health insurance database of National Health Research Institutes from 2004 to 2007, to explore the risk of causing esophageal diseases by demographic characteristics and inducement factors, and further analyze the medical utilization trend of the outpatient services for patients with both intellectual disabilities and esophageal diseases. The results indicated that in 2007, there were 1,684 patients with intellectual disabilities having esophageal diseases. The prevalence was 1.6%. Patients with profound intellectual disabilities, older, Catastrophic Illness, and taking anti-epileptic drugs or sedatives had a higher risk of getting esophageal diseases. The average annual medical cost of patients with both intellectual disabilities and esophageal diseases was NT$ 2,767, and the frequency that each of them went to the doctor was averagely 2.6 times a year. As the population age and life expectancy extends, there should be comprehensive consideration in planning the health promotion care project for patients with intellectual disabilities in the future. We suggest that decision-makers receive educations and trainings for related professions, and conduct esophageal disease screening to high-risk groups; caregivers should have cognition to esophageal diseases, and more importantly, inform medical units of patients' actual conditions, to promote the health care quality of patients with intellectual disabilities. |
