醫療臨床工作者的觀點探討台灣居家照護的現況與未來

健保自民國84年3月1日實施以降，台灣人民的平均壽命雖然有延長，但自民國84年至民國93年人口資料分析發現65歲以上失能人口比例不斷上升。台灣為因應失能人口照護需求，自民國84年3月1日將居家照護納入健保給付範圍，然而少子化更加速台灣的老化速度，且失能人口比例在民國84年至93年間卻不減反增，統計資料顯示需長期照護患者的每人平均醫療花費更是台灣全體人口的8.6倍，如果無法有效預防失能，將造成台灣許多家庭的重大負擔。長期照護制度施行至今歷經多次變革，本篇論文就衛生福利部相關政策及台灣相關統計資料做比較分析，同時以醫療臨床工作者的觀點探討長照制度實施以來，居家照護制度的現況與台灣目前所遇到的困境，期作為未來長照制度設計的參考。

關鍵字

老化；失能；長期照護；居家照護；在宅醫療

並列摘要

While the life expectancy of citizens in Taiwan has been on a steady rise since the government implemented the National Health Insurance (NHI) system on March 1, 1995, the number of disabled people in the elderly population reported a more rapid increase during the period from 1995 to 2004. Due to the increased need of long-term care for disabled patients, home care has been incorporated in the NHI system ever since the day of its implementation; however, instead of showing any sign of decline, the number of disabled older people was found to sustain a continuous rise from 1995 to 2004, incurring an average medical cost per capita 8.6 times higher than that of the general population. The problem has been aggravated by the steady drop in birth rate. It is thus obvious that the failure of the government to curb disability in the elderly population with effective measures for disability prevention and disability care will seriously worsen the economic burden of the families who need to take care of their disabled elders. Based on the principles of long-term care, this article focuses on examining the current status and predicaments of the home care system in Taiwan from the perspective of clinical physicians so as to help provide reference for the design and development of a sustainable long-term care system in the future.

並列關鍵字

aging ； disabled ； long-term care ； home care

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醫療臨床工作者的觀點探討台灣居家照護的現況與未來

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