Primary Health Care for People with an Intellectual Disability: A Mission Impossible?

People with intellectual disabilities (ID) have higher health needs and more complicated health problems than the general population. Despite this, they commonly encounter barriers in accessing health services. To ensure people with ID enjoy the same health rights as the general population, health care systems should develop appropriate health status monitoring procedures and community-based health services. The Taiwanese health care system is restructuring to focus on community-based services and primary health care (PHC) will be the main gatekeeper of health for the general population. However, there has been limited research into PHC issues faced by people with ID in Taiwan. This paper reviews recent literature about PHC for people with ID including the views of PHC providers on barriers and solutions to providing health care for people with ID in the community. Review outcomes reveal that general practitioners (GPs) consider they have a pivotal role in the PHC for people with ID. However, the role and function of GPs in the field of ID remain unclear and require clarification. Principal barriers for GPs include deficiencies in training, communication difficulties, an absence of statutory regulations and disincentives to treat time-consuming ID patients because of work pressures. The review highlights that health policy development needs to minimize these barriers and reorient health care systems to increase PHC accessibility, responsibility and equality for people with ID. In Taiwan, future research should focus on establishing evidence-based data to better understand perceptions, roles and priorities of health professionals in providing PHC to individuals with ID.

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