| Summary: | 碩士 === 國立中正大學 === 社會福利所 === 97 === Objectives
The aim of this study is to use qualitative evaluation as a measurement to exam rehabilitation services utilization of the disabled elementary school students in Chia-Yi. We evaluate the structure factors that affect utilization, and also the process and the outcome of the rehabilitation utilization.
Method
This study use the qualitative face to face interview for 12 parents (6 user and 6 non-user) and 5 service providers. Although the disabled elementary students are the rehabilitation services users, we interview their parents in stead since the attitude of their parents is a key determinant of the service process.
Result
First, in the characteristics of rehabilitation utilization, they can be divided into two dimensions. One is “the organizational characteristics of service providers affecting utilization”, it include, for example, the regulation of the National Health Insurance, the principle of priority setting, lacking of the service period in the night and weekend, and shortage of the human resources. The other one is “the characteristics of service user affecting utilization”, which include “predisposing” characteristics: the health beliefs about keeping use rehabilitation or the results of rehabilitation, and “need” characteristics: the shift depending on life course, perceived disabled degree.
Second, when we evaluate the process of rehabilitation utilization, it has two aspects. When we evaluate the process of use resources, we can find that there are four characteristics will affect utilization, those are, (1)flexibility of the job; (2)whether medical expenditure as a financial burden for the family or not; (3) care supporting system; (4) capability to go to service. In the other side, the study find the site that the disabled elementary students use rehabilitation have moved from regional hospitals or medical centers to district hospitals or rehabilitation clinics, and they also have used the services from special education system.
Third, when we evaluated the outcome of the service, especially consumer satisfaction, we found that the users may think, for example, lack of rehabilitation facilities for disabled children with higher body weights, the service time is hard to harmonize with the school and working time, the shortage resources in Chaiyi area, and too hard to be in the service list. Also, they may feel it is very hard to find service, lacking of the case management, and being thought as a waster. Finally, the result shows that, the relationship between the providers and the users inside the process of deciding and planning the utilization of rehabilitation, the users stand on the lower position to the providers.
Conclusion
Under the priority-setting principle of efficiency and equity, these students and their families have to spend more time on finding suitable rehabilitation institutions. Therefore, medical systems should notice how to harmonize the principle, user’s expectation and care quality. Moreover, to train human resources and to devise suitable facilities are also important.
Policy advice
(1)To train and investigate the sufficient of service providers for children rehabilitation care.
(2)To increase locations of community rehabilitation services.
(3)The equipment and service periods can suitable for users.
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