Trends in Rehabilitation Services Use in Chinese Children and Adolescents With Intellectual Disabilities: 2007-2013

Objectives: To investigate trends in rehabilitation services use in children and adolescents with intellectual disabilities, and to explore factors potentially contributing to the trends. Design: A population-based study using a multistage, randomized cluster-sampling process to ascertain participants in 2006. A subsample was selected for follow-up surveys from 2007 to 2013. Setting: Thirty-one provinces of China. Participants: Children (N=5432) aged 0 to 17 years with intellectual disabilities were followed up for 7 years. Interventions: Not applicable. Main Outcome Measures: The outcome variable was whether individuals received at least 1 of the following rehabilitation services in the past 12 months: occupational therapy, physical therapy, and speech or communication therapy. Results: Overall, the utilization rates of rehabilitation services significantly increased from 14.4% in 2007 to 37.1% in 2013. The trends were also significant in children aged 0 to 10 and 11 to 17 years, in boys and girls, and in rural participants. From 2007 to 2013, rehabilitation services utilization increased at an annual rate of 22.39% (95% confidence interval, 18.11%-26.82%) in the total sample. The rise was only significant in rural rather than urban individuals, resulting in the urban-rural gap in rehabilitation services use being narrowed. However, minority populations and those without health insurance still received fewer rehabilitation services than their respective counterparts. Conclusions: There were upward trends in rehabilitation services use in participants over time, and the urban-rural gap was narrowed. However, there were still socioeconomic differences on rehabilitation services use among children and adolescents with intellectual disabilities.