臺灣老年長期照護需求之推計─GEMTEE模型之應用

Projections of Future Long-Term Care Needs of an Aging Population of Taiwan -- An Application of GEMTEE

陳柏琪(Po-Chi Chen) ； 張靜貞(Ching-Cheng Chang) ； 陳肇男(Chao-Nan Chen)

《人口學刊》 51期 (2015/12) Pp. 43-93

https://doi.org/10.6191/JPS.2015.51.02

摘要

臺灣老人長期照護需求之長期推計需要兩項基礎資訊。一個是老人人口的長期推計，另一個是失能與失智率的推計。過去人口推計長期仰賴國家發展委員會以年輪組成法（cohort component method）加以估算，本文結合臺灣可計算一般均衡模型（General EquilibriumModel for Taiwanese Economy and Environment, GEMTEE）以及戶口普查與國民長期照護調查的兩種失能率，推計2011-2056年的長期失能人口趨勢。推計結果主要可歸納為以下幾項：（1）受到戰後嬰兒潮邁入高齡的影響，失能人口總推計數將從2011年的32-41萬人增加到2031年之68-85萬人，20年間成長一倍以上，至2056年，失能人口將較基期多出2-4倍。因此，除了機構型的支持系統外，如何發展社區型、居家型等多元支持系統，相關單位宜盡速規劃與推動。（2）相較於以國家發展委員會（國發會）為基礎版本所推估之高齡失能人口，本研究的推估人數較低，主要是因為本研究在考慮社會經濟變遷與內生化動態調整機制因素下，所推估之老年期死亡率會高於國發會的老年期死亡率，因此需要長期照護老年人口的基數也相對較低。（3）至2056年，65歲以上女性總失能人口較男性多出將近一倍。說明高齡族群與長期照顧之需求將有明顯的性別結構改變，突顯出長期照護已經不僅是社福議題，也是性別平等議題。因此，對於性別友善的照護環境以及高齡婦女之預防保健系統之建構應未雨綢繆。

關鍵字

人口推計 ； 失能人口推計 ； 長期照護 ； 臺灣可計算一般均衡模型

並列摘要

This study projects the future numbers of elderly care-dependent persons over 2011-2056 in Taiwan. The projections involve the future trends of elderly population and disability prevalence rates. Instead of using the cohort component method, the GEMTEE model -- a computable general equilibrium model with both investment and demographic dynamics -- is adopted to provide the forecast for Taiwan's elderly population. Our results show that: (1) The number of disabled elderly people is expected to increase sharply by 100%, i.e., twofold, over the next 20 years and by almost fourfold in 2056. This rapid growth calls for the development of sufficient formal and informal care delivery services to meet the future needs. (2) As compared to the forecasts based on the population projection of National Development Council, our estimates are lower and can serve as a lower bound. (3) By 2056, the number of disabled elderly women will be almost twice as many as which of men, which indicates the long-term care will face a significant gender imbalance problem. The government should give urgent attention to the development of a range of delivery options for gender-friendly living, medication, and caregiving support to meet the challenges of the growing gender imbalance.

並列關鍵字

population projection ； disability population projection ； longterm care ； GEMTEE

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