目標：探討台北市學齡前身心障礙兒童的醫療照護利用情形與所遇到的障礙。方法：針對民國89年底領有身心障礙手冊，而設籍台北市的1006名0～6歲身心障礙兒童之主要照顧者進行問卷調查，有效問卷共回收340份，回收率為33.8%。結果：過去四個月內，身心障礙兒童健保卡的平均使用格數為14.75格，有30.1%的研究對象曾到急診就醫；健保卡使用格數隨著兒童的年齡增加而減少，而需要復健治療之兒童，有較高的醫療利用；在住院與急診方面，隨著身心障礙的嚴重程度有較高的利用率。就醫障礙以主要照顧者的時間限制與醫療負擔之經濟因素為主要因素，主要照顧者期許政府優先辦理的事項以財務負擔及缺乏醫療資訊為主。結論：本研究顯示身心障礙兒童的醫療照護利用明顯的高於其他群體，突顯出對醫療照護的高度需求，相關的數據資料可供改善身心障礙兒童醫療照護之參考。

Objectives: To assess the healthcare utilization of preschool children with disabilities, and to identify the barriers of getting access to the healthcare services. Methods: A structured questionnaire was used to measure the healthcare utilization and barriers involving 340 of the main carers of preschool children with disabilities in Taipei and the total response rate was 33.8%. Results: The mean number of physician visits was 14.75 in the previous four months, and 30.1% children had ever utilized the emergency care. Responses differed slightly in physician visits with regard to the age of children with disabilities and rehabilitation necessity. The inpatient and emergency care utilization were related to the level of disability of children with disabilities. The research findings revealed that the main barriers of healthcare services confronting the parents of children with disabilities were time and economic burden of healthcare services. Conclusions: The health needs of preschool children with disabilities were greater than the general population. To ensure their health rights, the healthcare system should be restructured to ensure the accessibility and availability for children with disabilities.

身心障礙 ； 身心障礙兒童 ； 醫療需求 ； 醫療利用

disability, healthcare utilization, barrier, preschool children