居家服務使用決策是否存在區域差異?以長照2.0支付給付新制試辦計畫為例

Is there a regional difference in the decision to use the home care service? Take the Pilot project for Long-term Care 2.0 payment as an example

顏埕洲(Chng-Chou Yen)

指導教授 ： 韓幸紋

淡江大學/商管學院/會計學系碩士班/碩士(2019年)

https://doi.org/10.6846/TKU.2019.00208

摘要

台灣老年人口於2018年正式突破14%，臺灣正式邁入高齡社會，如何維護高齡人口的生活品質與尊嚴，以及解決高齡社會照顧與因應少子化現象等問題，皆是未來政府需要努力的重要目標。近年來台灣經濟快速發展，大量青壯年人口紛紛遷移至城市，城鄉差異日益嚴重，鄉鎮人口結構也逐漸高齡化，城鄉資源分配不均，也造成鄉鎮區域居家服務使用者使用居家服務的不便，又因使用者年紀越大，其對居家服務需求也會越高，因此本研究將探討區域因素對於民眾選擇使用居家服務和居家服務使用額度比例的影響。

資料來源為居家服務支付給付試辦新制之照顧服務管理資料庫，而長照試辦新制採行包裹制。本研究以區域因素作為主要觀察變數，並對可能影響民眾使用居家服務意願之變數進行控制，並進行實證研究來探討區域因素對民眾使用居家服務意願比例之影響。另進一步將使用居家服務個案進行分析，探討區域因素對民眾居家服務使用決策是否存在差異。本文結果顯示，城市區域其使用居家服務較鄉鎮高，與國內文獻結果亦同。區域因素與居家服務使用額度之間的關聯性，由實證結果發現呈現負向關係，代表意義為若為城市地區的使用額度比例相較於鄉鎮地區低。

關鍵字

長照2.0試辦新制 ； 居家服務使用因素 ； 使用額度比例

並列摘要

The elderly population in Taiwan has increased above 14% since 2018, making Taiwan officially an aged society. How to maintain the living quality and dignity of the senior citizens as well as solve the social care and respond to fewer babies phenomenon are the significant objects the government should devote more in the future. With Taiwan’s rapid economic development in recent years, a large amount of the young adults have been migrating to the cities, worsening the urban and rural differences. Also,the rural population structure tends to aging. The unbalanced resource distribution between the urban and rural areas results in inconvenience for those living in rural area to adopt the home care services. Further, the demand for home care services would increase with aging. Therefore, the study focuses on exploring the impact of regional factors on the adoption of home care services and its proportion.
The data originate from the Home Care Services Management Database of home care services newly trial provision system, and the Long-term Care Plan 2.0 adopts packaged policy. The study uses the regional factors as major observation variables, controls the variables that may affect the people’s willingness to adopt home care services, and make empirical research to explore the influence of the regional factors for the proportion of the people’s willingness to adopt home care service. Besides, further analysis of individual case study of home care services is made to explore if the decisions of adopting home care services vary with regional factors.
The result of this study reveals that the home care services are used more in urban areas than in rural areas, which is in line with the domestic literatures. Based on the empirical research result, the correlation between the regional factors and the proportion of adopting home care services shows a negative relationship, which means that the proportion of adopting home care services is lower in the urban areas.

並列關鍵字

Long-term Care 2.0 ； Factors related to the Home Care services ； User percent of amount

參考文獻

中文部分

朱敬一，2012，臺灣老化早十年, 老人產業輸入大陸商機大，聯合報。

吳振龍、紀櫻珍、黃國哲、莊坤洋、吳淑瓊，2004，社區失能老人居家支持服務需求之初探—以臺北市大安區失能老人為例，新臺北護理期刊，6:1期。

吳淑瓊，1998，老人長期照護政策評估，社會福利，138: P2-9。

吳淑瓊、莊坤洋，2001，在地老化：台灣二十一世紀長期照護的政策方向，台灣公共衛生雜誌，第20卷3期:P192-201。