臺北市某弱勢社區之整合性醫療照護

目的：評估弱勢族群醫療照護計畫施行之可能性，期幫助更多社區達到轉化及自我充能。方法：以大同之家為研究對象，進行社區健康評估，研究住民常見疾病與就醫需求，安排醫療團隊進行健康照護服務。結果：高血壓、心臟病、糖尿病、骨關節疾病、神經與精神疾病為住民常見疾病，依此需求辦理醫療服務，團隊介入後，高血壓與糖尿病住民皆已持續接受治療。胸部X光篩檢後轉診3位住民確定肺結核診斷並開始接受治療。醫療服務活動滿意度高達90%。結論：社區弱勢族群仍存在就醫困難性，需要醫院全體動員，提供住民可近、責任、持續、周全以及協調性之醫療服務，並擔任協調與整合者的角色，運用相關專業資源，幫助社區達到轉化及自我實現的發展與充能目標。

關鍵字

弱勢族群；整合性醫療照護模式；可近性醫療；充能

並列摘要

Objectives: Utilization of medical care depends on patients' income, the cost of medical services and the accessibility of medical services. For the disabled and the elderly, the accessibility of medical services is the most important factor compared to the other two. The aim of this study was to develop a health care program to empower the Ta-Tung Community, which is a minority community in a remote area within Taipei City. Methods: The timeline of this study was from October 2007 to September 2008 and seven healthcare activities were held. In total, 43 residents were included and their health was also investigated by questionnaire. Overall, 26 residents were found to be suitable for a health check-up that was provided by Bureau of Health Promotion. The aim of the survey was to investigate common diseases, to examine drug compliance, to discover the health status of residents and to empower this minority community. Results: Family medicine practitioners, a neurologist, an orthopedist, a general surgeon, a rehabilitation specialist, a Chinese herbal doctor, a nutritionist and a pharmacist participated in these health activities in this community based on the common types of diseases identified from the questionnaire. All residents who were found to have hypertension, diabetes mellitus and/or Parkinson disease as part of their history were referred accordingly and now under regularly medical control. Three residents were suspected to be suffering from tuberculosis, which was revealed during routine Chest X-ray screening. These were given appropriated medical treatment after diagnosis was confirmed. Conclusion: This research provides a model for approaching a minority community in order to develop a health care program. As a result of this intervention, the medical team recommended that the Department of Health allocate one blood pressure monitor to the community and to provide adequate health education so that local residents could check blood pressures themselves. The family medicine practitioners in this program played an important role in community health care by providing accessibility, accountability, continuity, comprehensiveness and coordination of the medical services. Not only were the activities important, this research also empowered residents in terms of self-care and daily blood pressure monitoring. This survey involved the cooperation of several departments within Taipei City Government. We are a public hospital and we will continue our efforts to maintain and improve this program as well as helping with the establishing similar programs in other minority communities.

並列關鍵字

minority community ； comprehensive health care ； accessibility medical services ； empowerment

國際替代計量

臺北市某弱勢社區之整合性醫療照護

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