目標：衛生政策上對智能障礙者的健康照護，往往忽略其健康需求與服務體系之評估，以致於此群體的健康問題在健康照護體系中僅獲得非常有限的注意；本研究主要目的乃以主要照顧者之觀點探討智能障礙者之醫療需求，以評估智能障礙者之醫療需求概況。方法：以深度訪談方式探討主要照顧者對於智能障礙者相關醫療議題之態度與信念，主要之評估面向包括（１）智障者主要醫療照護／復健需求為何？（２）在醫療照護服務中主要遭遇的問題為何？（３）對於目前的醫療保健制度／全民健保利用之困難何在？（４）自覺理想的醫療照護模式為何？結果：研究結果發現智能障礙者有高於一般人之醫療需求，他們在醫療照護過程中常面臨經濟上之困難，至於理想的醫療照護體系，主要照顧者通常沒有特別的期許，這問題遠超乎他們的想像。結論：為了確保智能障礙者與一般的國民享有同等的健康照護，健康服務體系應該尊重他們的權利與期許，設計提供滿足他們基本的健康服務，以增進他們的生活品質。

Objectives: The health care needs and problems of persons with intellectual disabilities (ID) have received limited attention in the health care system of Taiwan, and have been largely overlooked in the current health policy debate. The purpose of this study is to identify the health care needs of persons with ID based on the perspective of their main carers. Methods: Semi-structured in-depth interviews were conducted for 14 key informants in the study. The interview questions were open-ended and an interviewing guide was designed to encourage participants to share their experiences of working with and caring for people with ID. The interview questions covered four themes as follows: (1) What are the health needs of people with ID? (2) What are the problems regarding the health care services of people with ID and why? (3) What are the problems regarding the current health care system and National Health Insurance Plan for people with ID? (4) What is your ideal health care system for people with ID and why? Results: The research findings showed that the illness prevalence and health care utilization of people with ID were higher than the general population but their health care needs were not being properly met. The ideal health systems for people with ID were beyond the informants imagination and expectation. Conclusions: To ensure that people with ID enjoy the same rights as the general population, appropriate health care services suited to their needs are critical to the success of efforts to improve the quality of life for people with ID.

智能障礙者；醫療需求；主要照顧者；質性訪談

intellectual disabilities; health care needs; carer; qualitative interview