從服務使用者觀點探討身心障礙者鑑定與需求評估制度流程之研究

Exploring Procedures for Disability Evaluations and Needs Assessment for Persons with Disabilities: The Perspective of Services User

本研究以問卷調查法探討服務使用者（一般流程者及併同辦理者）對身心障礙者鑑定與需求評估新制申請流程（公所端、鑑定醫院端及需求評估端）之經驗、感受及意見。研究團隊與各縣市需求評估團隊合作，規劃發放522 份問卷，有效問卷為478 份，實際完成率為91.6%。研究發現，就申請流程方便性來說，選擇「併同辦理者」認為方便的比例大於「一般流程者」，且顯著差異（p<0.05）。在公所端方面，受訪者普遍認為公所人員未能清楚說明福利服務內容及表達性需求勾選，這樣的現象可能導因於公所人員人力不足、流動率高與缺乏充分訓練。其次，受訪者認為，「需多次往返醫院」是鑑定醫院端的主要困擾，民眾需多次往返醫院的現象，除因需進行多種鑑定科別外，「第二次鑑定」亦為主要原因。在需求評估端部份，受訪者指出等待評估及接受評估至獲得服務時程過久之問題。本文認為，立基使用者的觀點，政府未來除應思考，如何藉由更多資源的投入，增加併同辦理的比例外，亦應於公所設立身心障礙證明及福利服務單一窗口及排班或常駐社會工作專業人員，以加強福利服務及需求勾選說明；於醫院內設立身心障礙者鑑定服務窗口，並降低民眾往返醫院之次數；加強需求評估人力配置及主動服務機制，縮短需求評估等待期及提昇服務輸送效率，以保障使用者權益。

This study used a questionnaire survey to investigate the experience of users who participated disability evaluations and needs assessments. The survey was divided into three stages for examining three different aspects: the district affairs office, disability evaluation institutions, and needs assessment teams. The survey was sent to 522 participants; 478 complete responses were received, yielding a 91.6% response rate. The results of this study were as follows. In terms of the convenience of procedures, a statistically significant higher proportion of respondents agreed with 'consolidation of disability evaluation and needs assessment' rather than 'non-consolidation of disability evaluation and needs assessment. 'Perceived barriers for the district affairs office stage included respondents' opinion that district affairs officer cannot demonstrate the procedures and provide welfare service information clearly because of a lack of manpower, a high turnover rate, and insufficient training. In terms of disability evaluation institutions, multiple disability evaluations and the functioning scale evaluation were identified as two main reasons why applicants had to go to the hospital more than twice. Regarding needs assessment teams, the respondents pointed out that two periods in particular, that of waiting for the needs assessment and the interval between needs assessment and using welfare services, were too long. The findings of this study indicate that the government could consider the following measures, including increases of availability and the proportion of 'consolidation of disability evaluation and needs assessment', setup of one-stop window of applications for disability evaluation and welfare services with assistance of social workers at district affairs offices, setup of service window for disability evaluation at hospitals and reduction of applicants' multiple trips to the hospital, shortening of the waiting periods for needs assessment, and improvement of usage of welfare services.