||Cerebral Vascular Accident (CVA or stroke) is a disease of blood vessel of brain which is blocked by a clot or bursts, it leads to lesion of brain cells that is caused by the interruption of the blood supply and leads to dysfunction of the brain. It is one of the top three diseases leading the causes of the death in Taiwan. The mortality of patients with stroke has decreased in recent years, but the survivors have disabilities in various degrees. It is important to support patients to live meaningfully and with dignity. Occupational therapy is a important rehabilitation program to patients with stroke who can select, arrange and execute activities of daily living and it can improve quality of life by task-oriented treatments. Occupational therapy has been followed for years, but the research of utilization of occupational therapy services in recent years was rare.|
The sources of data of patients with stroke who use services of occupational therapy we claimed were came from sampled registry of beneficiaries of National Health Insurance Research Database from 2007 to 2010. According to the first phase behavioral model of health services use, we analyzed the utilization and fee of occupational therapy services and established the model of regression.
The prevalence of patients with stroke in Taiwan was 1.81% to 2.08%. Among those patients, 6.6% to 8.8% were using occupational therapy services. About 50% of patients use resource of inpatient services and 70% of patients use resource of outpatient services. According to the average utilization and fee, clinics provide more services than metropolitan hospitals and academic medical centers do, local community hospitals provide more services than metropolitan hospitals and academic medical centers do, occupation of the second, fifth, sixth class and dependant use more services than occupation of the third class, the group below NT $17280 and dependant use more services than the group from NT $17281 to $22800, low-income households use more services than non-low-income households do, patients with disabilities use more services than patients without disabilities do, patients with catastrophic illness use more services than patients without catastrophic illness do.
The following predicted factors of utilization and fee of occupational therapy services were significant. Utilization: catastrophic illness, disability, low-income households, hospital level, occupation, age and insured salary (adjusted R2=0.232); Fee: catastrophic illness, disability, hospital level, health insurance branch, occupation and age (adjusted R2=0.166).