小型長照機構的困局及其網絡治理策略研究

The Dilemma and Solution of Small-size Long-term Care Institutions: A Network Governance Approach

丘昌泰(Chang-tay Chiou) ； 楊澤之 ； 翁于晴

《第十屆發展研究年會　台灣經驗2.0：在地與全球的發展研究與實踐》 2018 (2018/10) Pp. 264-281

https://doi.org/10.6392/ACDS.201810.0007

摘要

本研究從網路治理角度探討小型長照機構的困境及其治理策略。據2018年衛生福利部統計，免辦財團法人登記、不對外募捐、不接受補助、也不享有租稅減免之49床以下的私人小型機構，為我國長照機構中佔比最大、數目最多，據點分布最廣的服務方式。然而，新修訂之《長期照顧服務法》施行後，小型長照機構面臨諸多的經營困境與存續危機。本研究發現：國內現行的長期照顧相關法令，對於私人小型機構的經營與轉型，仍存在著許多窒礙難行之處；相較於大型長照機構，小型長照機構未能與外部社會資源形成密切的網絡關係、過份仰賴政府與受顧者家庭所形成的「封閉式網絡」，使其治理能力薄弱；此外，本研究透過綜合相關文獻、制度法規與深度訪談發現，封閉式網路在治理上存有若干困境，包括人力、財力或其他方面的問題，將於研究最後提出政策建議，以供政府主管機關與長照機構經營者之決策參考。

關鍵字

長期照顧 ； 長期照顧服務法 ； 機構式長照 ； 社區式長照 ； 高齡化社會

並列摘要

The theme of this essay - the study of the dilemma and solution of ＂small-size＂ long-term care institutions - is approached from the theory of ＂network governance.＂ Long-term care has a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. Institutional long-term care plays an important role in Taiwan's long-term care services. The number of beds in the ＂small-size＂ long-term institutions are below 49 beds. Many problems have to be solved under the impact of the Long-Term Care Services Act revised on June 3, 2015. President Tsai announced that we have to establish a ＂high-quality, fair-price, and nonprofit-oriented long-care service system for Taiwan people.＂ Thus how to investigate the problems and solutions of ＂small-size＂ long-term institutions becomes an urgent public issue in this aging society. The research methods are literature review and depth interview. Several managers and owners in the institutional long-term cares are interviewed on a two-hour basis. This essay concludes that ＂small-size＂ long-term institutions have met with many institutional, financial, manpower as well as managerial problems. We finally recommends the government to help to improve the efficiency of small-size long-term care institutions with integrating the cooperative partnership of government, market and the NPO sector in Taiwan society.

並列關鍵字

Long-term care ； Long-Term Care Services Act ； long-term care institutions ； long-term care communities ； the aging society