從營運資源探討民間安養長照機構經營之困境

Study on the Predicament of Private Long-term Care Nursing Facilities from Operational Resources Perspective

羅慧文(Hui-Wen Luo)

指導教授 ： 喻肇青 ； 王如鈺

中原大學/商學院/企業管理研究所/碩士(2017年)

https://doi.org/10.6840/cycu201700613

摘要

本研究之目的係為探討民間長期照護機構經營之困境與出路，以研究者參與之11所在台北都會區之私立長期照護機構（養護中心）經驗為基礎，探討經營實務上的困難及政府政策面尚無法落實之問題，並試圖提出建議。
本研究之資料收集包括國內外論文、期刊等，以瞭解政府長照政策及長期照護的市場現況、需求與供給，以及業者的經營上的困境，並依據研究者之實務經驗，提出私立長期照護機構之營運要件作為分析架構，進行案例分析，以提出政府及民間資源如何協助民間長期照護機構解困之途徑。
本研究所稱「私立小型護理之家」長照機構，係指床位在5～49之私人創設的長照機構，其所提供的佔床率已達佔設立總床數的八成左右，而其定位與管理效能及人力資源成為長照政策的核心議題之一。私立小型長照機構目前面臨多重困境，如機構轉型為法人之法令矛盾、人力財務資源不足、經營管理效率欠佳，皆為實務上之關鍵問題。其中，私立小型長照機構面臨的營運最大問題來自於人力缺乏。
政府目前的長照2.0政策發展方向乃傾向於「在地老化、社區老化、小型化」，理論上，若能和遍布社區當中的小型機構做結合，應可發揮政策目標綜效；實質上，政府並未將私立小型長照機構納入長照政策規劃藍圖當中，忽略我國機構住宿式機構乃以私立小型機構為數最多，約佔全台八成。本研究分析的結果得知影響都會區私立小型長照機構發展關鍵因素：在硬體方面，機構所在區位及建築物空間條件影響服務品質；在軟體面，長照人力缺口、人員穩定性低且流動頻繁、評鑑制度未達目的等問題，影響營運成效甚鉅。
據此，提出了本研究之相關建議：善用資源、法規檢討與修法、建立多元化配套，社會企業、促進產學合作與社區結合探討人力資源。盼望政府日後制定長照政策上，應優先考量上述關鍵因素，並將廣設於社區當中的小型機構納入長照政策的藍圖，方能真正落實長照政策目標及其社會意義。

關鍵字

長期照護機構、長照政策、管理效能、人力資源

並列摘要

The purpose of this Research is to discuss the plight and solutions for private long-term care facilities in Taiwan. Base on the researcher’s experiences on operation of the 11 private long-term care facilities (maintenance center) in Taipei metropolitan area to discuss business practices on the difficulties as well as issues of the current policies in order to make some recommendations.
This data collection for this research includes literatures review, long-term care policy, needs and supply of market and dilemma of this industry. According to researcher’s practice experience and case analysis, this study intends to propose how the public and private resources can help the long-term care industry and find relief from the plight.
The term "private small nursing home" which discussed in this research is defined by the number of beds from 5 to 49 and occupancy rate is above 80%. The role, management effectiveness and human resources are the core issues for private small scale long-term care facilities.
There are multiple difficulties that private small scale long-term care facilities are currently confronting such as the legal contradiction of corporatization for private operations, shortage of manpower and financial resources, and management inefficiency, were key issues in practice.
The perspectives of current long-term care “2.0 policy” lean to "Aging in place, Aging in community, and miniaturization". Theoretically, if we can work with the small scale facilities throughout community, the policy target should be fulfilled. In fact, the government did not incorporate the private small long-term institutions into the picture; and ignored the fact that the total amount of small scale private facility is up to 80% among all institutions over the country. According to the result of this study, the major factors influencing the development of private small facilities in the metropolitan area are: physically, the location and condition of building are affecting the quality of service; and operationally, the shortage of professional, stability of manpower, and the ineffective assessment mechanisms affect the overall performance.
Accordingly, the proposed recommendations of this study: adequate resource management, regulatory review and amend the law, establishing a wide range related mechanisms, networking human resources with social enterprises, industry-academia cooperation and collaboration with community. Hope that the future policies of the long-term care service should give priority to these key factors, and establish small agencies in the community in order to realize the policy objectives and its social significance.

並列關鍵字

long-term care facilities, long-term care policy, management effectiveness, human resources

參考文獻

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