Epilepsy and Health Care Utilization among People with Intellectual Disability

智能障礙者合併癲癇及醫療利用之分析

林金定(Jin-Ding Lin) ； 嚴嘉楓(Chia-Feng Yen) ； 李志偉(Chi-Wei Li) ； 吳佳玲(Jia-Ling Wu) ； 卓妙如(Miao-Ru Chwo) ； 羅慶徽(Ching-Hui Loh) ； 賴朝英(Chao-Yi Lai)

《身心障礙研究季刊》 1卷1期 (2003/07) Pp. 65-77

https://doi.org/10.30072/JDR.200307.0006

摘要

儘管許多研究顯示智能障礙者合併癲癇患者的醫療照護體系存在許多問題，但極少有全國性的資料對此課題深入研究，本研究之主要目的乃在於調查台灣地區智障者之癲癇盛行率以及其主要的健康狀況與醫療利用情形。研究樣本以內政部民國89年12月底領有身心障礙手冊之智能障礙者為研究母群，經過分層系統抽樣，以郵寄問卷進行資料收集，共收回1071份結構式問卷為分析樣本。研究發現，智障者合併癲癇之盛行率為13.2%，智障者年齡與性別與癲癇盛行率有關，合併癲癇之智障者健康狀況較差，醫療利用率較高，定期服藥的比率也較沒有癲癇合併症之智障者高。癲癇是智障者常見的疾病之一，它造成不良的健康狀況與較高的醫療利用率，為了維持智障者良好的醫療照護品質，未來的研究必須著重於智障者抗癲癇藥物治療副作用之監測，醫療利用之可近性與可用性、預後及生活品質之改善分析等。

關鍵字

可近性 ； 智能障礙 ； 癲癇 ； 醫療照護利用

並列摘要

Background Although many studies have emphasized inadequacies in the provision of health care for people with intellectual disability (ID) accompanied by epilepsy, few studies have involved in a national survey of these people in order to determine levels of health care utilization in the ID population. This study was conducted to estimate the prevalence of people with ID accompanied by epilepsy and their health care utilization in the community, and in particular, their health status and use of primary health care services.
Method A sample from the National Disability Registration Database, Taiwan, classified by administrative geographical area, was systemically selected for the study. Statistical analysis of 1071 respondents was made to determine the health status and health care utilization for people in Taiwan with ID accompanied by epilepsy.
Results Findings showed a prevalence of 13.2% of individuals with ID who also have epilepsy. Age and disability level were associated with the prevalence of epilepsy. Those people with ID accompanied by epilepsy were reported to be unhealthier and to use health care services more frequently. They were also likely to take medicine more regularly (81.2% of cases) than those ID without epilepsy (25.9%).
Conclusions Epilepsy is a prevalent morbidity among people with ID, and it causes these people ill health and high health care utilization. To maintain the quality of health care for people with ID, future research should examine the effects of anti-seizure drugs among people with ID plus epilepsy, along with their health care accessibility and availability, as well as health outcomes and changes in quality of life.

並列關鍵字

accessibility ； epilepsy ； health care utilization ； intellectual disability

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