台灣長期照護之職能治療人力需要推估

Estimation of Occupational Therapist Manpower Needs for Long-term Care System in Taiwan

毛慧芬(Hui-Fen Mao) ； 紀彣宙(Wen-Chou Chi) ； 吳淑瓊(Shwu-Chong Wu)

《職能治療學會雜誌》 25卷2期 (2007/12) Pp. 32-52

https://doi.org/10.6594/JTOTA.2007.25(2).03

摘要

本研究為依據2000~2001年全國失能調查結果，推估2006、2010及2020年社區式與機構式長期照護所需之職能治療專業人力。研究樣本分為二部分：20至49歲樣本乃採用2000年台閩地區戶口普查資料中各年齡層之失能人口為推估樣本；50歲以上則採用2001年全國長期照護需要推估計畫之失能者。推估方法採以需要為基礎(need-based)之估算法，透過專家判斷，決定需要接受特定專業健康照護服務之需求，使個案接受到最適當醫療照護。本研究之推估步驟為：(1)決定各類型個案所需要之居家、社區定點、或機構服務等不同型態之服務內容與服務量，(2)以2000-2001年全國失能調查之相關資料庫，計算得出有長期照護職能治療服務需求之人口數推估數據，包含各性別、年齡層或障礙類型之失能率，居住社區或機構之比率等，3)依據上述數據及人口結構與成長狀態，推估西元2006、2010及2020年20歲以上失能者所需要之職能治療師人數，4)依不同之計算基準將社區式與機構式之職能治療人力需要分為低、中、高推估。社區式服務之高推估為專家認為個案能得到充分治療效益之理想狀況，中推估為考量有限資源下，能達到可接受之效益所提供之保守服務量，另依據過去實驗計畫中民眾實際接受服務的比例乘以中推估，此為低推估。結果顯示：20歲以上需要長期照護職能治療的失能人口從2006年之307,706人（社區，274,608；機構，33,098），增加為2010年之354,447人（社區，316,676；機構，37,771），及2020年之487,496人（社區，436,608；機構，50,888）。就中推估而言，2006年，長期照護體系中職能治療人力整體需要推估為1929人；其中，社區式及機構式人力需要分別為1648人和281人；2010年時，整體需要為2237人；其中社區式及機構式分別為1916人和321人；2020年時，整體需要為3131人，社區式及機構式分別為2698人和433人。本研究結果顯示未來人口結構老化之趨勢，使得長期照護領域中需要大量職能治療專業人力投入，其中有近九成比例需提供社區式的職能治療服務，且未來服務的年齡層以高齡或超高齡長者為多。目前長期照護職能治療人力雖無法滿足低推估所需，但至2020年時人力應較無匱乏，故應及早進行職能治療專業人力之規劃與培訓，並加強社區式服務及高齡族群之相關知能訓練，以使長期照護體系中具有質與量均備的職能治療人力，提昇國內長期照護之服務品質。

關鍵字

長期照護 ； 人力推估 ； 職能治療

並列摘要

This study estimates the number of occupational therapist needed in years 2006, 2010, and 2020 to serve disabled persons above 20 years old in long-term care (LTC) system, based on the nationwide surveys in 2000 and 2001.
The results of two national surveys were used to estimate the number of disabled population for our study. The first sample was from the 2000 national census for people aged between 20 and 49 years old, while the second was from the Taiwan Long-Term Care Need Assessment Study recorded within 2001. The need-based approach, in which the need is determined by the profession's clinical judgments, was applied to estimate the number of occupational therapists needed. The four estimating steps were as the following: 1) to determine the type, content, and the amount of occupational therapy (OT) service available in LTC, including community and institutional care, 2) to calculate the rate of OT needs among disabled persons according to data from the two national surveys, 3) to estimate the manpower needed in OT for years 2006, 2010 and 2020 according to the amount and projected change of population structure and growth in the future, and 4) to determine the manpower needed in OT each year on three projection levels (low, middle, and high according to different criteria). In community care, high projection was based on the amount of service necessary to provide an optimum standard of health care. The middle projection refers to the amount of services to satisfy a given set of standard within the status of limited resources. The low projection was based on the percentage of the population who would seek or purchase OT services in an experimental project.
The results indicated that 307,706 disabled people above 20 years of age need occupational therapy in 2006 (274,608 within community and 33,098 within institution). There will be an estimated 354,447 people in 2010 (316,676 community / 37,771 institution), and 487,496 people in 2020 (436,608 in community/50,888 in institution) who require such services from OT. The Journal estimated middle projection value of manpower needed by OT in LTC system for persons older than 20 years old in 2006, 2010 and 2020 are 1929, 2237, and 3131 respectively. These calculations indicated that both the community-based and institution-based services are in a great need of manpower within occupational therapy in the long term care system; therefore, it is necessary to plan and provide training programs for OT professionals working in the LTC system so that improvements could be made in the quality of such services. Presently, there are not enough OT personnel to provide adequate quality of service as expected from that of professional standards, but it is expected that in 2020, the lack of manpower would not be a concern.

並列關鍵字

long-term care ； manpower estimation ； occupational therapy