新世紀台灣啟智專業展望－以醫療衛生領域為例

The New Era of Intellectual Disability Profession in Taiwan: A Perspective in Healthcare Services

10.30072/JDR.200307.0001

林金定(Jin-Ding Lin)；吳佳玲(Jia-Ling Wu)；嚴嘉楓(Chia-Feng Yen)；李志偉(Chi-Wei Li)；李宗派(Isaiah C. Lee)

個案主導模式 ； 智能障礙者 ； 醫療利用 ； 醫療需求 ； consumer-directed approach ； health care need ； health care utilization ； intellectual disability

身心障礙研究季刊

1卷1期（2003 / 07 / 01）

1 - 19

繁體中文

健康是基本的人權，每個國家應該設法滿足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。智能障礙在公共衛生上是一個重要議題，智能障礙者比其他群體有較高的罹病率與造成二次殘障機會，因此他們隱含著較高的醫療需求及醫療花費。由於智能障礙者本身智能不足加上合併有許多障礙，他們在醫療上大多經歷了醫療利用的困難，所以在醫療相關政策制定上的適切性就必須謹慎思考；儘管過去國內的醫療照護政策及研究極少論及智能障礙課題，但消除他們就醫的障礙與滿足他們的醫療需求，乃是醫療照護體系責無旁貸的重要課題。智能障礙群體異質化之特性，因此個案管理更是重要，過去智能障礙服務措施主要以機構式的照顧型態為主，主要以機構專業人員的觀點來設計他們服務內容，甚少讓智能障礙者有足夠參與決策的機會，以致於他們所接受到的服務難以真正符合他們的需求，如何創造身心障礙者參與決策之機會，制定符合他們自身需求之支持性服務，是決策當局的一大挑戰。因此未來身心障礙之研究策略，要邁向利用研究特有的價值、增加對身心障礙知識的提昇、促進他們的福祉、創造更文明之社會以及更創新更有效的問題解決導向的研究為主，這些目標有賴跨領域及跨部門的合作關係之建立，以及將身心障礙者視為社會的一份子之態度，才能成功。

Health as a fundamental human right, should be protected. In Taiwan, current health policies neglect the health needs of people with intellectual disability, moreover, their health needs have received limited attention in the health care system. Health care service problems for persons with intellectual disabilities in Taiwan include: how to enforce the discovery system and early intervention service, disability evaluation system, National Health Insurance medical payment and medical care resource development are still confining their quality of care. Furthermore, the links between social welfare, education and health care have been lost because the dual roles of scientists and social reformer are fundamentally at odds with one another. Health care scientists have become less reform minded as a consequence of the conditions of their work. Consequently, a complete and coordinated health care policy for persons with intellectual disabilities becomes unattainable in society. Therefore, a big challenge in health care policy development will be how to deal with the above problems, which decrease quality of care for persons with intellectual disabilities, and provide sustainable and appropriate health care services for them. In order to create a sustainable health care policy for people with intellectual disability, comprehensive health care planning, and multisectoral and interdisciplinary collaboration should be improved.

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