身心障礙兒童之健康不均：以醫療福利資源利用面向探討

Health Inequality in Children with Disabilities: Medical and Social Welfare Utilization Perspective

從許多身心障礙兒童的健康相關研究發現，他們的確有較差的健康情形及較高的醫療利用，本研究即以「健康不均（Health Inequality）」的觀點檢視身心障礙兒童在醫療及福利服務使用與一般群體的差異，藉由整理身心障礙兒童在醫療及福利服務使用相關文獻，深入了解身心障礙兒童接受療育服務的相關因素。研究方法以PubMed 資料庫檢索，主要關鍵字包括身心障礙、身心障礙兒童、健康不均、發展遲緩等。「健康不均」隱含對健康不公的關懷與道德評價，所以本研究期待先藉由文獻回顧瞭解影響身心障礙兒童在醫療、福利資源的使用或其健康情形，以及探討可能受到那些結構性因素影響造成其健康不均，更期待在目前以國際健康功能身心障礙分類系統（International Classification of Functioning, Disability and Health, ICF）為鑑定及需求評估基礎的衛生福利政策上提供未來身心障礙兒童福利配置的參考依據。

Children with disabilities have higher health needs than the general population, and their health needs are different and require more specialized services. There are evidence reported poorer health outcomes and less effective health interventions encounter by children with disabilities in Taiwan, and other countries as well. Closing the gaps of health inequalities between children with disabilities and general children is a vital priority in health service policy. The aim of this study is to describe the health care and social welfare service profile and to investigate the associated factors in these services for children with disabilities and their family based on current reference reviews. We searched references in PubMed as the following key words: anthropogenic delayed, children with disabilities, disability, and health inequalities. Results reveal that the occurrence of health inequalities of child with disability is affected by many social factors such as poor economic, poor living conditions, families with unemployed and discrimination than their body impairments solely. The future health welfare policy should consider the new disability identification system - International Classification of Functioning, Disability and Health (ICF) to initiate appropriate health and welfare services for this population.