Outcomes and Costs of Residential Services for Adults with Intellectual Disabilities in Taiwan: A Comparative Evaluation

Abstract

Background The disability policy in Taiwan has traditionally emphasized residential care in large institutions and, more recently, medium-sized group homes. This paper compares the relative costs, services provided and outcomes between the traditional institutions, mediumsized group homes and new small-scale community living units that were launched in 2004 in Taiwan. Materials and Methods Cross-sectional analysis was used to investigate the three current residential service models. A total of 248 participants with intellectual disabilities were interviewed, including all residents from the existing 25 small residential units and purposively sampled respondents from the other two residential models. ResultsOutcomes for the Taiwanese participants were consistent with the existing literature on deinstitutionalization from Western societies. Small homes provided better subjective and objective quality of life than both medium-sized community-based units and traditional institutions. Conclusion Participants living in small residential homes experienced better outcomes at lower cost than persons living in medium-sized group homes or institutions.

Outcomes of a new residential scheme for adults with intellectual disabilities in Taiwan: a 2‐year follow‐up

“…There are a number of implications from this finding. First, this suggests (as found in previous studies; Chou et al . 2008) that the choices available in ‘where to live’ and ‘who to live with’ were not made by the residents.…”

“…As described previously, small ordinary residential models like this new scheme have just started in Taiwan. In Chou et al . 's (2008) study, consistent with Western studies, the evaluation of this community‐based new residential scheme for adults with IDs has shown that it is the most cost‐effective choice when compared to institutional care, but the service structure in Taiwan is still dominated by institutional care.…”

“…The reliability of these instruments has been previously assessed using 248 residents with IDs who use small residential homes, group homes and institutions in Taiwan. Reliability scores (Cronbach's alphas) among these 248 residents are 0.96 and 0.71 for ABS‐I and ABS‐II respectively, 0.87 for the QoL‐Q, 0.84 for the RCAS and 0.81 for the UCFS (for more details, see Chou et al . 2008).…”

Are adults with intellectual disabilities socially excluded? An exploratory study in Taiwan

“…It is definitely a major limitation in this study. Moreover, as noted in both Power (2008) and Chou et al . (2008), Western countries strongly favour the deinstitutionalisation of adults with ID, where the provision of support to live in their own homes within the community has become a mainstream policy.…”

Perspectives on intellectual disability in Taiwan

“…Moreover, people with intellectual disability living in small residential homes experienced better outcomes at lower cost than persons living in medium-sized group homes or institutions [33]. In addition, staff working at small homes had a significantly higher level of job satisfaction than staff in other types of institutions; the characteristics of the residential setting are thus factors of concern when ensuring staff job satisfaction [34 ].…”