私立老人小型長期照顧機構評鑑指標分析

臺灣已邁入高齡化社會，需要廣泛的長期照護服務。為因應長期照護的需求，政府除了廣泛設置長期照顧機構之外，也透過長期照顧機構評鑑維持其照護品質。由於過去較少研究針對評鑑之後各項評鑑指標結果分析以及對每3年重複評鑑機構品質的維持做探討，本研究採探索性重複觀測分析台灣南部某市於2013年與2016年受評皆獲優等、甲等、乙等共25間私立小型長期照顧機構之各大項指標，期望本研究的結果能帶給往後受評機構與政府相關單位未來制訂相關辦法、執行與輔導之參考依據。研究結果顯示經過3年評鑑，優等之機構在各項評鑑項目都保持一定的照護水平；甲等之機構在權益保障、加分題及扣分題大項有些許的進步，但進步幅度不大，所以無法升為優等。比較特別的發現結果是乙等之機構在生活照顧及專業服務、環境設施與安全維護大項都呈現顯著的進步，然而卻因2016年扣分題的扣分項目和比重都提高，扣分分數也顯著的增加，導致乙等之機構等第維持不變，不過這也代表乙等之機構確實有因評鑑制度的設立，努力其達到評鑑項目之要求。這也表示評鑑制度能有效監測機構的照護品質，是有存在的必要。

關鍵字

老人；機構評鑑；評鑑指標

並列摘要

Taiwan is an aging society, where long-term care services are broadly needed. In order to fulfill the demand, not only did the Taiwanese government encourage the set-up of long-term care institutions, but also maintained the service qualities of them via an effective appraisal system. However, prior research paid little attention to the appraisal indicators and the content analysis for appraisal results. The purpose of this study is to conduct a repetitive exploratory observation of the appraisal results from the year of 2013 and 2016 in the hopes of providing future references for both the governments and the institutions. Samples include 25 private institutions of Level A, B, C in a southern Taiwanese city. Our research results show that, after 3 years of appraisal, the Level A institutions maintain high service qualities; on the other hand, the Level B institutions make significant progress on the Rights Protection, Bonus, and Deductions domains. Most interestingly, while the Level C institutions demonstrate greater progress in Life Care and Professional Services, Environmental Facilities, and Safety Maintenance domains, they receive greater Deductions as well, which keeps them from elevating to Level B. Nevertheless, the necessity of the appraisal system for long-term care institutions is evident.