從績效資訊角度論地方政府績效管理制度之規劃與執行：以長期照顧十年計畫2.0為例

2026年我國老年人口比率將超過20%為「超高齡社會」，老年人口比率逐漸攀升也意味著高齡社會的來臨其老人安養與照顧問題越趨棘手。為此，國家發展委員會將「長期照顧十年計畫2.0」（簡稱長照2.0）列為行政院列管重要計畫，由主管機關衛生福利部訂定中長程計畫、年度施政計畫，並且每年施行「地方衛生機關業務考評」，長照業務為其依考評項目，檢視該年度各地方政府的執行成效。地方政府如何因應中央政府之考評，並且發展其自主的績效管理模式，並且避免績效悖理之現象，探析績效資訊之運用以及瞭解影響績效表現之績效體系的樣貌，尤其重要。基此，本研究以績效體系與績效資訊之理論視角，針對長照業務的「地方衛生機關業務考評」執行實情，剖析其運作現況並回答以下研究問題：一、長照政策的績效管理制度的規劃為何？有哪些執行問題？；二、面對由上而下的管理制度，地方政府如何運用績效資訊進行管理，其策略與行為為何？運用過程受到那些要素影響？；三、應用績效資訊於績效管理過程中，面臨那些挑戰？為解答上開研究問題，以衛福部、地方政府相關主責與承辦機關以及相關服務單位為研究對象，透過深度訪談法並輔以文件分析法，以長照業務的「地方衛生機關業務考評」為焦點，探究其績效管理之實際情形以及與理想之間的落差。最後，本研究認為長照政策之績效管理邁向品質監測之階段，應更加注重整體服務輸送流程之各環節的網絡，以及委託代理關係建構之的互動合作。因此績效體系之制度系絡與績效干預對於績效管理的檢視有更寬廣的視野，助於進一步瞭解績效資訊之運用情形。對此，提出三大研究建議，一、應建立績效管理制度之雙向反饋機制避免績效悖理之產生；二、透過績效體系之視野檢視與修正管理制度；三、績效資訊於績效管理過程中之重要性應明朗化且建構學習環境。

關鍵字

長照2.0 ；績效管理；績效體系；績效資訊；地方衛生機關業務考評

並列摘要

In 2026, the population aging will exceed 20% as an " Aging Society" in Taiwan. In other words, the gradual increase in the ratio of elderly population also means that with the advent of an aging society, the problem of nursing and care for the elderly has become more and more difficult. To this end, the National Development Council has listed the “Long-term Care Program 2.0” (referred to as “Long-term Care 2.0”) as an important project under the administration of the Executive Yuan, and the Ministry of Health and Welfare of the competent authority has formulated a medium-term and long-term plan and coordination of annual governance plans. The “Business Evaluation of Local Health Angencies” is carried out every year, and the long-term care business is one of evaluation item based on the evaluation of the performance of each local government in annual year. How local governments respond to the central government's evaluation and develop their performance management models? How to avoid the so-called “performance paradoxes?” It is important to analyze how the locals use of performance information, and understand the connotation of the performance regime. Based on the theory of performance regime and performance information, the study analyzes the practice of the Long-term Care Program 2.0 with Business Evaluation of Local Health Angencies, and try to answer the following research questions: 1. What is the planning of the performance management system of the long-term care policy? What are the implementation issues? 2. In the face of the top-down management system, how does the local government use performance information to manage, and what are its strategies and actions? What are the factors that affect the application process? 3. What are the challenges in applying performance information to performance management? To answer the above research question, the study taking the Ministry of Health and Welfare, the responsible and undertaking agencies of the local government and relevant service units as the research objects, through in-depth interviews with document analysis. Focusing on the “Business Evaluation of Local Health Agencies” of Long-term Care Program 2.0, it explores the actual situation and the gap between its performance management and ideal. Finally, this study believes that the performance management of the Long-term Care Program 2.0 is moving towards the stage of quality monitoring, and more attention should be paid to the network of each link in the overall service delivery process and the interaction and cooperation in the construction of the principal-agent relationship. Therefore, the institutional context and performance intervention of the performance regime have a broader perspective on the inspection of performance management, which helps to further understand the application of performance information. In this regard, three research proposals are put forward: 1. The two-way feedback mechanism of the performance management system should be established to avoid the occurrence of performance paradox; 2. Review and revise the management machnism through the perspective of performance regime; 3. The importance of performance information in the performance management process should be clarified and the learning environment should be constructed.