Assistive Device Rental/Purchase, LTC Service Use, and Caregiver Burden in Taiwan

The Association Between Assistive Device Approval, Rental or Purchase Types, Long-Term Care Service Utilization, and Family Caregiver Burden in Taiwan: A Secondary Data Analysis of the Long-Term Care Service Database

The goal of this observational study is to examine the associations between assistive device approval and acquisition modality (rental or purchase), long-term care service utilization, and family caregiver burden among individuals receiving long-term care services in Taiwan. The study will use de-identified nationwide long-term care administrative data from 2021 to 2022.

The main questions it aims to answer are:

1. What individual, disability-related, socioeconomic, residential, and caregiving factors are associated with assistive device approval, the number and type of approved devices, and rental or purchase modality?
2. Are assistive device approval and utilization patterns associated with the use of formal long-term care services and with family caregiver burden?

Inclusion Criteria:

• Individuals with a valid long-term care case record (CA100) in Taiwan's long-term care database between 2021 and 2022.
• Individuals with at least one valid assessment or care plan record (CA110) that can be linked to the corresponding CA100 record.
• Availability of interpretable key study variables, including individual and assessment/care plan identifiers, care plan status, and Case-Mix System (CMS) level or other core disability-related information.
• For analyses of assistive device utilization, the presence or absence of an assistive device record (QD113) and its approval status must be identifiable.

Exclusion Criteria:

• Records with missing key linkage variables that prevent establishment of relationships among individuals, care plans, assistive device records, or service utilization records.
• Records identified as invalid, cancelled, test records, or records whose validity cannot be determined.
• Records in which primary study variables cannot be interpreted.
• Records with clearly implausible values for variables such as individual age, caregiver age, CMS level, number of assistive devices, or service utilization that cannot be corrected according to prespecified data-cleaning rules.
• Records with inconsistent or contradictory date information that prevents valid determination of an index date or observation period.