從日本資料分析介護保險開銷與服務利用的關係

Analyzing Correlation between Cost and Service Utilization of Long-term Care Insurance based on the Case of Japan

楊秉勳(Ping-Hsun Yang) ； 蔡岡廷(Kang-Ting Tsai)

《台灣老年醫學暨老年學會雜誌》 14卷2期 (2019/05) Pp. 115-124

https://doi.org/10.29461/TGGa.201905_14(2).0006

摘要

關於台灣長期照護未來的走向，國內各種不同的意見中最常被提起的就是開銷的問題。長期照護開銷事關重大，在擬定政策之時必須考量維持能負擔的開銷，政策才能永續推行。由於台灣老化速度與日本接近，本文從日本厚生勞動省的資料中分析介護保險開銷與各種介護服務之間的關聯性。這份資料提供給我們的訊息包括：日本失能人口約佔老年人口18%、居宅系服務是日本長期照護的主流、長期照護保險開銷隨個案失能嚴重程度提高、同樣失能等級情況下居宅系服務開銷顯著低於施設系服務、以及施設系服務利用比例越高則長期照護開銷越高。未來隨著老年人口比例提高，台灣的長期照護狀況可望與現在的日本更加接近。我們希望經由日本介護保險的經驗，能對台灣長期照護體系的建構產生一些啟發。

關鍵字

長期照護 ； 開銷 ； 介護保險

並列摘要

＂Cost＂ has been an issue of grave concern when it comes to the development of the long-term care system in Taiwan. Affordable cost indeed plays a crucial role in determining whether the formulated policies are capable of facilitating sustainable development of a long-term care system. In light of the similarity in the rate of aging between Taiwan and Japan, the study aims at analyzing related data from the Ministry of Health, Labour, and Welfare in Japan to examine the correlation between the cost and utilization of the services offered by its long-term care insurance program. Major insights obtained from the analyzed data include: disabled or dependent older adults account for approximately 18% of the elderly population in Japan; visiting home care is the mainstay of long-term care; the cost of long-term care insurance rises with the severity of disability; the cost of visiting home care appears to be significantly lower than that of institutional care for elderly people with the same level of disability; and greater utilization of institutional care leads to higher cost of long-term care. With an ever-increasing pace of aging, Taiwan is highly likely to face a future long-term care situation similar to the current one in Japan. It is therefore the hope of the authors that learning about the experience of long-term care insurance in Japan can benefit the implementation and development of the long-term care system in Taiwan.

並列關鍵字

long-term care ； cost ； long-term care insurance