專科醫師對於勞保失能年金評估制度之看法

Medical Specialists' Opinions on the Evaluation System for the Disability Annuity of Labor Insurance

本研究探討勞保失能年金評估參數包括全人障礙程度、年齡、職業等因子外，是否仍需考量其他因子而更符合我國失能年金制度。由專家會議並收集意見，對象為100位各科專科醫師，進行問卷調查，以SPSS window 17.0.將十種因子納入研究。其信度檢定，結果內部一致性Cronbach's a=0.81，已達可信。因素分析共得到三類主要因子：失能狀況（a=0.78）、心理因素（a=0.80）及工作前景（a=0.67）。其中較大解釋變異量於因素一，該組成因子中除「職業重建潛力」外，均在現有勞保主要參數中（包括全人損傷率、未來工作收入能力、職業等）。有八成以上的專科醫師認為失能嚴重度、職務對失能部位需求、年齡、職務所需體能強度、職業重建潛力及未來工作收入能力為相當重要。整體而言，目前勞保失能評估因素皆為重要，其中以失能嚴重度或加重度為主要影響因素，然而失能勞工的心理因素亦相當重要，但如何客觀評估以及探討工作與失能之相關性具有難度，仍需進一步研究探討。

This study focuses on systems of paying disability annuity of labor insurance assessments, including parameters such as permanent disability rating, age, occupation and future earning capacities and other adjusting factors that need to consider whether they also conform to disability pension system. Expert meetings were held to collect feedback opinions about the system and parameters, and ten factors for survey were determined. We then collected questionnaires from 100 board-certified specialists and analysis was performed using SPSS window 17.0. The reliability test results showed among the 10 factors with high credibility (Cronbach' s 0.81). Factor analysis showed three main factors, the first is working disability (Cronbach' s 0.78); the second is mental factor (Cronbach' s 0.80),and the third is work perspective (Cronbach' s 0.67). Factor 1 explained the largest amount of explained variance. These parameters, except vocational rehabilitation potential or possibility, are already included in current regulation. Over 80% of the specialists think that the severity of disability, occupational characteristics, age, occupational strength, vocational rehabilitation potential or possibility, and future earning capacity are very important. Current disability annuity of labor insurance assessment parameters are considered important, among them the severity or aggravation of disability are the most important ones. However, supporting environment of disabled workers especially mental factor is also very important though difficult to assess objectively. In order to explore the relatedness between work and disability, further study may be warranted.