台灣長期照護制度的發展與國際比較－兼論社區物理治療的定位

The Development of Long-term Care in Taiwan and an International Comparison

蔡誾誾(Yin-Yin Tsai)

《物理治療》 32卷2期 (2007/04) Pp. 45-50

摘要

本文主要參考國內外各一篇的文獻，都分別針對長期照護制度發展的國際比較，二篇研究對比較國家的選擇，相當一致，應是著眼於德、日、英、美及北歐等國家在長期照護的需求與供給分別有不同典型的運作方式，且人口基本結構改變趨勢與產生的問題大致類似，但每個國家則發展出不同的長期照護政策與體系來對應。依循二篇文獻國際比較的分析架構，本文也試著探討台灣長期照護制度的發展，從照護需求的趨勢、服務體系建置的問題及財務支持的爭議等面向加以比較，也回溯政府部門在2002年全國社會福利會議，已擬具發展長期照護制度的政策思維。同時本文也回顧物理治療專業參與台灣921震災社區重建計畫卓著績效，是其參與社區工作的重要起始點，並對物理治療若要持續社區部份的專業發展，提出界定工作範疇及人力養成教育的建議。最後，本文作者以其過去參與長期照護計畫研訂與執行時，所秉持的價值信念作為結語。

關鍵字

長期照護 ； 社區物理治療 ； 照護政策

並列摘要

This thesis mainly refers to two research papers that compared the development of long-term care (LTC) arrangements in several countries. The two papers are rather consistent in their choices of countries studied: Germany, Japan, England, the United States, and the Scandinavian countries. Although the countries aforementioned share similar trends in fundamental demographic changes and subsequent problems, they have developed different long-tem care policies and systems in response. Observing the analytical framework of these two research papers, this one explores the controversial issues of demands, provision, and finance of LTC in Taiwan. It also reviews the LTC policies propounded by the government in the National Social Welfare Policy Conference 2002, Taiwan. Furthermore, it examines, in retrospect, the participation of physical therapists in the community reconstruction programs after the 921 earthquake disasters and commends their outstanding achievements. Additionally, the author suggests that to elevate the level of service to the community, the leaders in the PT profession should clearly define a scope of work and propose a new training curriculum geared towards community service. To conclude, the author offers her personal beliefs and values on the development of long-term care system.

並列關鍵字

Long-term care ； Community physical therapy ； Care policy