台灣長照服務的系統性視角研究

Study on Long-Term Care in Taiwan

趙忠傑(Chao, Chung-Chieh) ； 張碩學(Chang, Shuo-Hsueh)

《臺灣台北醫療聯盟學術期刊》 1期 (2021/01) Pp. 5-25

https://doi.org/10.29498/TMAAJ.202101_(1).0001

摘要

本研究通過文獻分析法與深入訪談法兩種研究方法，梳理臺灣政府長照服務的政策，瞭解臺灣長照服務的困境與解決方案。本研究發現臺灣長照服務體系存在兩個較大的問題：長照服務的供給沒有與需求端契合；長照人力資源嚴重缺乏，非機構式照護大量仰賴外籍勞工。通過深度訪談的資料分析，本研究借用系統思考的模型，呈現臺灣長照服務的結構性問題，並初步提出可能解決方案：第一，政府積極干預，制定相關政策。以政府協助輔導的方式，頻繁的到各長照機構去做巡迴式的輔導，取代效果不彰三年一次的定期評鑒督導；與產業界展開密切溝通，儘快修正不切實際的法律規範；針對外籍勞工問題，政府必須有計劃的介入，改善外勞晉用條件、提高外籍社福以及提升勞工的專業工作水準。第二，促進社會力量進入。積極引導社會企業的建立，吸引更多社會企業參與長照服務產業，改善產業的工作環境與社會觀感，增加人力供給，進而斬斷非法聘雇與人力缺乏的惡性循環。

關鍵字

系統思考 ； 臺灣 ； 長照服務 ； 結構性問題

並列摘要

Through two kinds of research method: literature analysis and in-depth interview on government departments and relevant personnel, we combine the Taiwan government long-term care service policy and understand the problems. In our opinion, there are the existence of market failure in the long-term care service system with two problems: the supply is not fit on the demand; there is serious shortage of human resources and rely heavily on foreign workers. Through the construction of system dynamics model, we simulate different kinds of policy and find two possible solutions: firstly, the government should involve with industry expansion close communication and fix unrealistic laws and regulations as soon as possible. The government must make a plan to improve the social welfare of the migrant workers, and enhance the professional work level of foreign. Secondly, the government could rely on social forces, and actively guide the establishment of social enterprises, increasing the whole industry human supply, and cut off the vicious spiral of the illegal employment and the lack of human resources.

並列關鍵字

System Thinking ； Taiwan ； Long-term care ； Structural Problems