日間照顧中心佈點過程公私協力經驗之探討-以南臺灣三縣市為例

在福利多元主義與民營化的浪潮下，公部門引進民間單位加入福利服務提供，希望藉此降低財政支出、增加服務效率與服務品質，以滿足日益增加的福利需求。國內面臨龐大且迫切的長期照顧需求，為了建置綿密的長期照顧資源，長期照顧十年計劃2.0中亦強調公私部門的夥伴關係，在日間照顧中心快速佈點的過程中，民間組織扮演了重要的角色，如何保持良好的公私部門互動是公私協力是否成功的關鍵。故本研究欲在此政策背景下，以公私協力的觀點探討南臺灣三縣市政府與民間單位在日間照顧中心佈點過程中的互動關係。本研究以台南市、高雄市與屏東縣這三個縣市為研究範疇，採用焦點團體法，邀請三位地方政府的主管機關業務主管，以及七位在三個縣市辦理日照中心的民間單位負責人，並以質性分析方法進行文本分析。藉由文本分析得出中央政策形塑的日照中心佈點過程中公私協力樣貌，並比較三縣市的經驗，最後分別歸納出公私部門在日照中心佈點過程中的協力過程以及障礙。最後依據上述結論，提出以下建議：一、建議中央政府制定具體完善的制度規劃、提升評鑑制度的獎勵誘因、了解偏鄉需求並發展特色制度；二、建議地方政府整合內部跨單位、與民間單位共同參與並發展長期關係、與民間單位建立平等與信任關係；三、建議民間單位加強單位專業量能、發展健全財務運作。

關鍵字

日間照顧中心；公私協力；長期照顧

並列摘要

Under the trends of Welfare Pluralism and Privatization, the government starts to collaborate with private sectors to provide welfare services for reducing the fiscal burden, improving the effectiveness and quality of services to satisfy the increasing needs. Domestically there are great and emergent needs for long-term care. In order to construct intensive long-term care resources network, the Long-term Care Decade Plan 2.0 also emphasizes the Public-Private Partnerships (PPPs). During the process of establishing day care centers, private organizations play an indispensable role. How to keep good relationships between public and private sectors is the key to the success. Under the context, this thesis used PPPs perspectives to discuss the relationships between public and private sectors. This study selected the experiences of Tainan city, Kaohsiung city and Pingtung county. Utilizing focus group method to collect data, the three in-charge administrators of local government and the seven persons in charge of day care centers among the cities were invited. The data was analyzed via textual analysis method. The findings show that the pictures of PPPs during the process of establishing day care centers were shaped by the central policy. In addition, through comparing the experiences of the three cities, the collaboration process and barriers of PPPs in establishing day care centers were inducted. According to the above results, we provide some suggestions as below. (1) The central government should make specific and complete policy, build an evaluation system to raise up the service providers’ motivation level, and assess the needs of remote areas to develop featured institution. (2) Local government should integrate the intra-agency efforts, participate together with private sectors and develop long-term, equal and trustful relationship with them. (3) Private sectors should enhance their professional capability and develop healthy financial operation procedures.