臺灣民眾對老人照顧安排偏好之影響因素

當今高齡化社會多關注老人照顧如何供給，惟家庭社會學或社會福利學既有的理論及研究成果卻不能妥適回答臺灣民眾老人照顧安排偏好究係以非正式或正式照顧何者居多。本研究沿用Andersen模型為研究架構，使用台灣社會變遷基本調查計畫第七期第二次家庭組調查資料，擇定年齡等十個自變項，並將「年老到需要被照顧時最希望獲得的照顧方式」區分為非正式照顧、混合式照顧及正式照顧等三組為依變項，採用多元邏輯迴歸分析（Multinominal Logistic Regression）探討自變項的預測力。研究結果發現約有一成五的臺灣民眾選擇非正式照顧，約六成選擇混合式照顧，約二成五選擇正式照顧，而前置因素七個自變項（年齡、性別、配偶或伴侶、教育程度、孝道觀念、性別角色態度、福利態度）及使能因素二個自變項（個人收入、養育子女數）共九個自變項在不同老人照顧方排方式之比較選擇上均具有統計上顯著影響力，且依其影響力範圍還可再區分為五種類型，至於需求因素（健康程度）則不具統計上顯著影響力。考量臺灣民眾沒有特定的老人照顧安排偏好，當前臺灣政府推行「長期照顧十年計畫2.0」或能因應老人照顧需求，惟近年臺灣社會人口有單身化趨勢，家庭作為一個生活共同體所具有社會風險共同分擔的功能，將因年輕世代多不願組成家庭不復存在，本研究建議透過社區營造或社區培力方式，建構無婚姻及血緣者相互協助的生活共同體，作為非正式照顧體系的替代品。最後，由於過往對於家庭結構的想像總忽略單身家庭及同性婚姻家庭，建議未來研究者進一步探究非傳統異性婚姻及非核心家庭的老人照顧安排偏好；另囿於次級資料限制，未能將最常被使用的正式服務「居家服務」納入依變項內涵的未竟之處，同樣建議未來研究者補充討論臺灣民眾對居家服務的偏好及比較選擇。

關鍵字

長期照顧；非正式照顧；正式照顧；社區式照顧；機構式照顧

並列摘要

People nowadays pays more attention to how elder care services are provided in aging society. But unfortunately, sociology of the family or theories of social welfare still cannot properly explain what’s the preference of Taiwanese citizens for elder care arrangement and what would they choose from informal or formal care. In this thesis, the Andersen model is applied as the research framework, and ten independent variables such as “age” and dependent variable “preference for elder care arrangement” which is divided into three groups: informal care, mixed care and formal care are selected within the data from “2016 Taiwan Social Change Survey (Round 7, Year 2): Family”. Then, statistical analysis was done by doing multinominal logistic regression to realize how all the independent variables could be used to predict the preference. The findings are respectively about 15% Taiwanese citizens prefer informal care, and about 60% prefer mixed care, and about 25% prefer formal care. On the other hand, the 9 predisposing factors which are age, gender, having spouse or partner or not, education level, attitude to filial piety, attitude to gender norm, attitude to welfare and the 2 enabling factors which are individual income and numbers of children all have statistical significant influence on preference of elder care arrangement in 5 different ways. But the need factor which is health status does not. Considering Taiwanese citizens do not have specific preference for elder care arrangement actually, the current public policy “National Ten-year Long-term Care Plan 2.0” seemed to be capable of coping with the needs of elder care in Taiwan. However, the proportion of single household to traditional family is increasing because younger generation would not to get married. Thus Family as an informal care system which can share the risk of living will no longer exist. So constructing non-married and non-biological-related community which its members could care each other as a substitute for family was recommended. Finally, since single household and same-sex marriage family are ignored in the past discussions and studies about family structure, it is recommended to study the preference of non-heterosexual-marriage and non-nuclear families for elder care arrangement in the future. Furthermore, under constraint of limited secondary data, the dependent variable in this thesis excluded home care which is also a kind of formal care and most often used, it is recommend to study the preference for home care in the future as well.