助燒燙傷友一臂之力!

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2011 / 6月

文‧陳歆怡


在全民健保開辦前,燒燙傷患者無菌病房、數次植皮手術的費用動輒上百萬元,讓必要的治療難以為繼。如今,在健保制度及國內醫療水準提升下,患者都能享有基本的就醫權,但仍須面對復健期間及後續就業上的經濟風險,需要你我的關懷。


依健保局公告,凡「2度燒燙傷面積大於全身20%以上,或3度燒燙傷面積大於全身10%以上,或顏面燒傷合併五官功能障礙者,」可申請重大傷病卡,醫療費用由健保全額給付,患者僅需支付掛號費與少部分的自費項目(例如請看護、特殊用藥等),估計住院治療期間約需自費數千元。

若因燒傷造成身體某部位的功能障礙,可向各縣市社會局申請身心障礙手冊,以及相關社福資源(包括托育養護費用補助、輔具補助、就學費用減免、稅捐減免等)。

在復健期間,醫療費用主要花在購買輔具、藥品、定期回診的交通費及掛號費等。以最必要的輔具──壓力衣而言,陽光重建中心提供從量身、打版、試穿到定期修改等直接服務,一套全身壓力衣價格為10,150元(是民間廠商的6~7成),需做兩套以便輪流穿洗,6~8個月後就需要更換。

陽光基金會副執行長林瑞嬌指出,在漫長的治療及復健過程中,患者可能面臨的經濟壓力,來自於身為家中主要經濟來源卻被迫中斷職業,加上不少人雖因職災受傷,卻可能因雇主逃避責任,未能獲得應有的補償與保險給付,有待政府介入協助。

考量到有些重度患者一時無法自理生活,且家人也無法承擔照護工作,陽光基金會設置有護理人員陪伴的中途之家,提供給有需要的傷友(住宿費用每月2千元外加200元清潔費),每年服務約40人。此外,對於家庭經濟面臨困難的傷友,基金會經實際評估後,提供一半至全額的「輔具」補助,以及每月最多1萬元、最長為期2年的「生活重建」補助,其他還有復健交通及醫療特材補助。2010年經濟補助共1,027人次,總金額約600萬元(其中6成為口腔癌病友的營養補助)。

林瑞嬌表示,長期以來,陽光的收入來源有55%仰賴小額長期捐款(每月500∼1,000元),然而,受到不景氣影響,基金會預算已連續數年為赤字。此外,因陽光在復健領域的用心與專業度,使得服務案件有增無減,且以嚴重燒傷者為大宗,近年更主動拓展至更為邊緣無助的口腔癌病友的復健及防治工作。陽光感謝各界愛心與信任,讓他們可以持續陪伴燒燙傷及顏損患者度過幽谷。

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EN

Giving Burn Victims a Helping Hand

Chen Hsin-yi /tr. by Jonathan Barnard

Considering that hospital stays in germ-free rooms and multiple skin graft procedures can often run to more than NT$1 million, many burn victims in the era before National Health Insurance in Taiwan were forced to discontinue treatment. Today, with universal health insurance and rising medical standards, everyone enjoys access to basic medical care. But the challenges that burn victims face in rehabilitation and reemployment should be a concern to all.


According to the Bureau of National Health Insurance, "Whenever second-degree burns cover more than 20% of the body, third--degree burns cover more than 10% of the body, or facial burns impair the functioning of facial organs," a patient can apply for a "serious injury card" from the BNHI that will cover the vast majority of medical expenses. These patients only have to pay registration fees and a small portion of the normal copayments. Typically, they'll only have to spend several thousand NT dollars per hospital stay.

If burns result in disabilities, then patients can apply to the welfare bureaus of city or county governments for disability booklets and other social welfare resources.

During rehabilitation, medical expenses largely arise from the purchase of assistive equipment, prescription drugs, transportation to and from doctor's appointments, hospital registration fees and so forth. With regard to pressure garments-the most essential assistive equipment-the Sunshine Social Welfare Foundation Rehabilitation Center provides services such as measuring, pattern making, fittings, and regularly scheduled tailoring. A full set of pressure clothing costs NT$10,150 (60-70% of what it would cost from a for-profit manufacturer). It's necessary to buy two sets, so they can be worn and cleaned in turn. Every six to eight months, patients will need new ones.

Lin Jui-chiao, Sunshine's deputy CEO, points out that during the long process of treatment and rehabilitative therapy, patients often face financial pressures if, as their family's main breadwinner, they are unable to work. What's more, employers often attempt to evade responsibility for many of those who are injured on the job. The workers then have to wait for the government to intervene on their behalf.

For the seriously injured who can no longer take care of themselves but also lack family members to assume fulltime caregiver responsibilities, Sunshine has established a halfway house with a nursing staff. Every year it serves about 40 patients. What's more, the foundation also offers grants covering half or more of the cost of assistive equipment, as well as up to NT$10,000 per month in "recuperative living" assistance that can be extended for up to one year. There are also grants available to cover transportation expenses and more specialized medical equipment.

Lin explains that Sunshine's hard work and professionalism have brought it a growing number of clients, most of whom have severe burns. In recent years the foundation has actively expanded into providing rehabilitation and therapy for oral cancer victims, a group that has traditionally been marginalized. Sunshine is grateful for the trust and compassion it has received from all quarters of society. These have allowed it to support burn victims and others suffering with facial wounds through their times of need.

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