長期照護保險法制服務輸送可行方案之探討

To Investigate the Feasible Care Delivery Systems for Long-term Care Insurance

張淑卿(Shu-Ching Chang) ； 林麗嬋(Li-Chan Lin) ； 蔡誾誾(Yin-Yin Tsai) ； 吳肖琪(Shiao-Chi Wu)

《長期照護雜誌》 14卷3期 (2010/12) Pp. 241-253

https://doi.org/10.6317/LTC.201012_14(3).0001

摘要

長期照護保險服務輸送設計應考量「全國適用」、「以人為中心」、「便民且可近性高」、「公平公開且符合成效的機制」、「中央與地方分工」、「與現有長期照護體制無縫接軌」及「與全民健康保險無縫接軌」等七大原則，服務輸送流程從申請、受理、訪視評估、需求分級判定、照顧計畫、服務提供至複評可分為七個階段。在現階段縣市長期照顧管理中心提供服務之能力及數量差距極大，政府開辦長期照護保險之責信及收支平衡永續經營的考量下，建議由保險局統籌辦理；長照服務、資源管理、開發、及整合則由地方政府負責；保險局依據人口多寡，各縣市應設置一個以上之受案據點，以便接受長照需求民眾就近申請。負責訪視評估及照顧計畫之照顧管理師資格，未來朝專業認證。品質部分應儘速建立長期照護服務法、品質資料庫及評鑑機制，並辦理長期照護品質相關教育宣導。

關鍵字

長期照護 ； 保險 ； 服務輸送

並列摘要

Long term care (LTC) services delivery system should include seven principles such as universal, client oriented, convenient and accessible for clients, cost-effectiveness with equitable and disclosure, intergovernmental coordination, seamless link with current long term care system and national health insurance. This delivery system could be divided into 7 parts including application, processing, home evaluation, need assessment, care plan, services supply and claims. Considering the big gap of LTC assessment and management between county and city, and accountability of LTC insurance system, the LTC services delivery system should be run by Bureau of LTC Insurance. The resources management, development and integration of LTC services could be run by local government. According to population size, bureau of LTC will set up at least one assessment center in each county/city to ensure accessibility. The care manager in charge of assessment and care planning should have license in future. To assure quality of services, the Act of LTC Services, databank of quality assurance, accreditation of LTC services, and mass education should be established.

並列關鍵字

long-term care ； insurance ； care delivery system