「以社區為基礎」的照顧模式之檢視：網絡治理觀點的分析

Reviewing a Community-based Care Model: Perspective of Network Governance

莊俐昕(Li-Hsin Chuang) ； 黃源協(Yuan-Shie Hwang)

《臺大社會工作學刊》 44期 (2021/12) Pp. 133-173

https://doi.org/10.6171/ntuswr.202112_(44).0004

摘要

本研究旨在從網絡治理的觀點檢視〈長照1.0〉與〈長照2.0〉的實務運作狀況，據以提出建構「以社區為基礎」之照顧模式的相關建議。研究採取質性研究方法進行，立意選取具代表性的專家學者及公、私部門的行政與實務工作者進行個別深度訪談及焦點團體。研究顯示，〈長照1.0〉與〈長照2.0〉具有六項優勢及七項劣勢。依據研究發現，本研究從網絡治理的觀點，提出六項供推動「以社區為基礎」之長期照顧服務的相關建議，包括：（1）增進網絡單位對夥伴關係的認知，打造長照網絡治理的利基；（2）強化跨部門與跨專業的整合與協力機制；（3）導入「以人為本」的理念，激發利害關係人參與網絡的動力；（4）適切配置資源及簡化行政流程，以促進治理的共識；（5）發掘並善用社區內外資源，以強化社區照顧的能量；（6）加強投資偏遠地區之照顧服務，以增進服務的質與量。

關鍵字

社區照顧 ； 網絡治理 ； 長期照顧 ； 以人為本實務

並列摘要

This study aims to explore the practical operation of ＂Long-term Care 1.0＂ and ＂Long-term Care 2.0＂ from the perspective of network governance, as well as to propose relevant suggestions for the construction of a ＂community-based＂ care model. In order to achieve the above aims, this study was conducted with qualitative research methods, and purposefully invited representative experts, scholars, administrators and practitioners in the public and private sectors to conduct individual in-depth interviews and focus groups. The research results show that ＂Long-term Care 1.0＂ and ＂Long-term Care 2.0＂ have six advantages and seven disadvantages. According to these findings, this study puts forward six relevant suggestions for promoting ＂community-based＂ long-term care services from the perspective of network governance, including: (1) Enhancing the network's awareness of partnerships to create a niche for long-term care network governance; (2) Strengthening the mechanism of cross-departmental and cross-professional integration and coordination; (3) Introducing the ＂person-centered＂ concept to stimulate the motivation of stakeholders to participate in the network; (4) Allocating resources appropriately and simplifying administrative procedures and promoting the governance consensus; (5) Exploring and making good use of resources inside and outside the community to strengthen the energy directed at community care; (6) Strengthening investment in care services in remote areas to improve the quality and quantity of services.

並列關鍵字

community care ； network governance ； long-term care ； person-centered practice

參考文獻

李佩芳、鄭清霞（2019）。〈臺灣社區整合照顧的經驗與挑戰：以健康照護專業服務為例〉，《社會政策與社會工作學刊》，23(2)，179-223。doi: 10.6785/SPSW.201912_23(2).0005 【Lee, P.-F., & Cheng, C.-H. (2019). The experience and challenge of community - Based integrated care in Taiwan: The example of health care services. Social Policy & Social Work, 23(2), 179-223. doi: 10.6785/SPSW.201912_23(2).0005】

陳正益（2019）。〈社區整體照顧服務體系之運作與展望：以南投縣為例〉，《社會政策與社會工作學刊》，23(2)，137-177。doi: 10.6785/SPSW.201912_23(2).0004 【Chen, Z.-Y. (2019). The operation and prospects of the community integrated care service system: A case study of Nantou county. Social Policy & Social Work, 23(2), 137-177. doi: 10.6785/SPSW.201912_23(2).0004】

陳正益、吳書昀、黃源協（2012）。〈我國長期照顧管理實踐經驗之檢視〉，《長期照護雜誌》，16(3)，257-272。doi: 10.6317/LTC.201212_16(3).0004 【Chen, Z.-Y., Wu, S.-Y., & Hwang, Y.-S. (2012). Reviewing the implementation of long-term care management in Taiwan. The Journal of Long-Term Care, 16(3), 257-272. doi: 10.6317/LTC.201212_16(3).0004】

黃源協、莊俐昕（2018）。〈長期照顧夥伴關係的「應然」與「實然」之研究：對長期照顧十年計畫 2.0 的意涵〉，《人文社會科學研究：教育類》，12(4)，1-27。doi: 10.6618/HSSRP.201812_12(4).1 【Hwang, Y.-S., & Chuang, L.-H. (2018). The study of ‘rhetoric (ought)’ and ‘reality (is)’ of long-term care partnership: Implications for the long-term care decade plan 2.0. NPUST Humanities and Social Sciences Research: Pedagogy, 12(4), 1-27. doi: 10.6618/HSSRP.201812_12(4).1】

Appuhami, R., Perera, S., & Perera, H. (2011). Management controls in public-private partnerships: An analytical framework. Australian Accounting Review, 21(1), 64-79. doi: 10.1111/j.1835-2561.2010.00122.x