Characteristics of the Home Service Utilization for Older Adults in Taiwan

台灣老年人居家服務利用特性分析

劉立凡(Li-Fan Liu)

《台灣老年醫學暨老年學雜誌》 4卷3期 (2009/08) Pp. 187-202

https://doi.org/10.29461/TGG.200908.0005

摘要

目的：基於在地老化之政策，居家服務乃為內政部所推動的重要方案。本研究目的希望由使用居家服務接受者的角度了解我國老年人在居家服務利用的特性以及此方案的效果。
方法：本研究採用橫斷面研究調查並以面對面訪談方式進行。選取一個樣本城市所有居家服務支援中心約50%的服務個案為對象，共完成327位個案或其家屬之訪談。
結果：雖然2/3受訪者對服務表示滿意但46%個案仍表達有未被滿足之需求。研究發現社會人口學變項之年齡及其功能狀態是主要居家服務利用的影響因素，同時也受財務介入狀態所影響。實務面上目前仍存在服務利用與部分負擔概念的落差。一般而言，居家服務個案充分利用補助時數；一般戶較低收入戶較少使用生活照顧，只有少部分受訪者完全自費。
結論：實務上迫切須要服務方案的定期監測以確保個案需求的滿足和資源的有效配置，台灣居家服務成敗與否端賴其搭配之長期照護需求，並能真正增進其在社區中的生活品質。

關鍵字

居家服務 ； 服務利用 ； 社區照護 ； 老年人 ； 台灣

並列摘要

Objectives: Based on the policy of ”Ageing in Place”, Taiwan government has initiated the program of community-based care, of which a home service program subsidized by the Ministry of Interior (MOI) is regarded as an essential part. In order to integrate policy theory and practice, and improve service planning and capacity, this study was aimed to approach the characteristics of home service utilization of older adults in Taiwan and the effect of this program from the service recipients' point of views to assure the satisfaction of long-term care needs to the service recipients.
Methods: A cross-sectional survey was designed and the service recipients were investigated by face-to-face interviews. A stratified random sampling method was used to sample 50% service recipients from all four home service centres in one sample city. In total, 327 service recipients or their principal family members were interviewed.
Results: Two thirds of the recipients were satisfied with the service, however, as many as 46% expressed unmet needs. Among the service recipients, the specific socio-demographic and functional characteristics were the significant factors influencing utilization, which were also intervened by financial means. In practice, there was a gap between service utilization and co-payment. In general, the recipients fully utilized the subsidized home service hours; however, ordinary income households tended to use less living care than low income counterparts, while only a small percentage of the home service utilization was paid exclusively by their out-of-pocket cost.
Conclusion: Regularly monitoring the long-term care needs of service recipients and resources allocation is imperative. The success of home service programs in Taiwan will depend on its performance that matches long-term care needs and improves their quality of life in the community as a whole.

並列關鍵字

home service ； utilization ； community-based care ； older adults ； Taiwan