以醫療社福專家觀點初探智能障礙者理想醫療照護模式

The Normative Perspective towards Healthcare Service Development for People with Intellectual Disabilities

林金定(Jin-Ding Lin) ； 嚴嘉楓(Chia-Feng Yen) ； 李志偉(Chi-Wei Li) ； 吳佳玲(Jia-Ling Wu) ； 陳美花(Mei-Hua Cheng)

《身心障礙研究季刊》 1卷2期 (2003/10) Pp. 32-42

https://doi.org/10.30072/JDR.200310.0004

摘要

目標：健康是基本的人權，每個國家應該設法保障其國民的基本的健康需求，不論其膚色、種族、階級與身心障礙與否。智能障礙者往往需要比常人需要更多的醫療照護、社會福利、教育、職訓及保護等服務，而適當的健康照護服務是保障及維持智能障礙者生活品質的重要關鍵。智能障礙者的醫療需求問題在整個醫療照護體系中往往被忽略，以致於此群體的健康問題在健康照護體系中僅獲得非常有限的注意；本研究主要目的乃以醫療與智能障礙專家的觀點，探討智能障礙者利用醫療照護之困境與未來智能障礙者合適的醫療照護模式。方法：以立意取樣選取9名在智能障礙領域專家進行質性深度訪談，探討專家們對於智能障礙者相關醫療照護制度之態度與信念，主要之評估面向包括智能障礙者對於目前的醫療保健制度／全民健保利用之困難何在，以及理想的智能障礙者醫療照護模式為何？結果：研究結果發現，專家們普遍認為全民健保對智能障礙者而言提供良好的醫療照顧，但是就醫掛號費及自付額方面造成他們經濟負擔過重，醫療與福利資訊不足，以及健保復健給付設計不當，常造成復健利用沒有效率。至於理想的醫療照護體系方面，智障者就醫掛號費免費或部分負擔減免措施，克服醫療人員與智能障礙者之間的溝通障礙，改善醫療人員對智能障礙者之負面態度，復健人力的培育與規劃健全復健制度，以及醫療福利政策完整配套系統規劃是當務之急。結論：完善的公共衛生計劃必須涵蓋社會中每一份子，傳統上身心障礙群體常為國家衛生政策所忽略，為了確保智能障礙者與一般的國民享有同等的醫療照護，醫療照護服務體系應該戮力於解決其醫療障礙，致力於設計適合他們的醫療照護模式，以提昇其醫療照護品質。

關鍵字

智能障礙者 ； 專家面向 ； 質性訪談 ； 醫療照護模式

並列摘要

Objectives: Health is fundamental human right, and must be protected. In Taiwan, current health policies neglect the health needs of people with intellectual disability (ID) and they have received limited attention in healthcare system. The purpose of this study is to identify the healthcare barriers and ideal healthcare policies for people with ID based on the normative perspective. Methods: In-depth qualitative interviews were conducted for 9 key informants in the study. The interview questions were open-ended and interviewing guide was designed to encourage participants to share their experiences of working with and caring for people with ID. The interview questions covered two themes as follow: What are the problems regarding the current healthcare system and National Health Insurance (NHI) Plan for people with ID? And what are the ideal healthcare policies for people with ID and why? Results: The research findings showed NHI supported the basic healthcare needs for people with ID, but it still have many problems need to be improved. The healthcare system should be reoriented to increase health care accessibility, responsibility and equality for people with I.D. Conclusions, In order to create an appropriate healthcare policy for people with ID, the healthcare system should be improved. This is particularly important in the areas of decreasing the barriers of healthcare services and revising NHI payment system and subsidy policies.

並列關鍵字

health care development ； intellectual disability ； normative perspective ； qualitative interview

參考文獻

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內政部

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