英日兩國長期照護制度對推動我國長期照護制度之意涵

The Long-term Care Systems in the United Kingdom and Japan: A Lesson for Taiwan

梁亞文(Yia-Wun Liang) ； 劉立凡(Li-Fan Liu) ； 林育秀(Yu-Hsiu Lin)

《長期照護雜誌》 14卷3期 (2010/12) Pp. 311-324

https://doi.org/10.6317/LTC.201012_14(3).0006

摘要

台灣人口老化速度已躍升全球第一，因此，我國進入超高齡社會的準備期較其他國家短。爰此，本文針對英國、日本長期照護制度的理念／政策發展、組織體制、給付對象、給付方式、服務項目、服務輸送體系、財務機制等進行比較分析，期能提供我國推動長期照護制度參考。
本文建議：我國應以居家照護為手段，追求在地老化；中央、地方同時擔負政策、資源和財政平衡與整合的責任；整合現有社政、衛政與退輔資源，建立銜接急性、亞急性與慢性的連續性照護；財源可包含保險費、稅收、政府補助及個人負擔，確保財源兼具風險分攤及社會福利的公平性與合理性；設定部分負擔，避免資源濫用與浪費；透過高可近性的服務窗口，統籌資格審核及照護計畫的擬定與管理監督；統一需求評估工具，並依需求者經濟條件給予不同程度補助及補助上限，以達財務管控。

關鍵字

長期照護 ； 在地老化 ； 英國 ； 日本

並列摘要

Taiwan has become the fastest growing aging populations' nation in the world and therefore Taiwan's time to response the population aging is shorter than the other nations. This paper compares the characters of long-term care system and its major components, including development, organizational structures, insurance coverage, payment system, services, delivery system, and financial mechanism, in the United Kingdom and Japan. Hoping the study results can be useful reference to Taiwan's policy makers in implementing the long-term-care system.
The results of our study suggest that aging-in-place can be achieved by implementing home care. The central government and the local government simultaneously take responsibilities for policy, resources, and finance. To build up a continuous care system, including acute care, sub-acute care and long-tern care, by integrating the social system, health system, and veteran system. Major financing sources should come from premiums, tax, and government subsidy to avoid the risks and reach the equity. Co-payments are applied to all provided services to avoid the resources abused. Providing a high accessible service delivery system and adopting a unified evaluation tool to evaluate the insured's needs. Financial control mechanisms including setting the subsidy ceiling and the subsidies provided based on the insured's economic conditions are suggested.

並列關鍵字

long-term care ； aging in place ； United Kingdom ； Japan