私立小型長照機構於台灣長照政策趨勢下之發展與因應對策

本研究主要在探討私立小型長照機構在長照政策轉變中的處境與回應，以及在現行的長期照顧發展趨勢下，私立小型長照機構未來可能之發展，並藉由研究發現，對私立小型長照機構的發展提出建議。採取質性研究的研究方法，以半開放的深度訪談針對過去參與過長照政策討論的政策參與者、集團式住宿式機構經營者及單一私立小型長照機構經營者等三類研究參與者，進行相關議題之研究資料蒐集，再以主題分析法進行研究分析。本研究主要的發現為：一、「三不政策」限制了機構經濟規模，以致機構對政策的變動存在著排斥與被動接受，以及對於長照政策規劃早存在「無法預期」的不信任感。二、小型機構形成的地方性或全國性協會等利益團體因核心價值的公益性不足，在政策討論的場域的影響力有限，小型機構逐漸發展出與國家發展不同調的形象。三、長照政策推動的過程中，政府與小型長照機構溝通不足，使得小型長照機對轉型法人組織存有疑慮並採取觀望與排拒的回應策略。四、經營者的管理角色很大程度影響私立小型機構的發展。五、由於住宿式機構的服務存在著不可替代性，當社區式的照顧服務難以滿足社會的長照需求時，政策關注的重點仍需回頭關注住宿式機構的發展。而本研究對於私立小型長照機構的建議為：小型機構應有核心價值，使其更具公益性，而地方性與全國性協會應強化相關長照議題倡議的功能性，而小型長照機構也應屏除保守態度，主動適應長照的發展潮流。另對政府相關單位提出的建議為：期待未來與私立小型機構的政策溝通應更友善積極，政策的思考須更具彈性，對於一致性的標準可再檢討。

關鍵字

私立小型長照機構；台灣長照政策；三不政策

並列摘要

This Study mainly examines the situation and response of private small-scale long-term care institutions in the policy change prosess, and the possible future development under the current trend of long-term care. This study also proposes recommendations for the progress of long-term care institutions. This study adopts qualitative research methods, wihich semi-opened interviews is carried out and Thematic Analysis is used in order to analyse data. Three types of research participants are targeted: policy participants who have participated in long-term care policy discussions in the past, group-style residential institution operators, and single private small-scale long-term care institution operators. This study includes five main findings. 1. The "Three No Policy" restricts the economic scale of the organizations, so that there have been rejection and passive acceptance of the policy changes, which means long-term institutes have an "unpredictable" distrust of long-term care policy planning. 2. Interest groups such as local or national associations formed by small institutions have limited influence in the field of policy discussion due to the lack of public welfare of their core values and gradually shape the image that the development of small institutions are different from the national policy. 3. In the process of promoting the long-term care policy, the government and small-scale long-term care institutions have insufficient communication, that results in these institutions having doubts about the transformation of legal person organizations and adopt a wait-and-see and reject response strategies. 4.The managerial role of the operators dramatically influences the development of small private organizations. 5. As residential institutions' services are irreplaceable, when community-based care services cannot meet the long-term care needs of society, the policy's focus still needs to tale care of the development of residential institutions. The recommendations of this research for private small long-term care institutions are: small-scale institutions should have core values to make them more charitable, and local and national associations should strengthen the functionality of related long-term care issues, and small long-term care institutions. The conservative attitude should also be removed and proactively adapted to the development trend of long-term photography. Another suggestion made to relevant government agencies is: expecting that policy communication with small private institutions in the future should be more friendly and active, policy thinking should be more flexible, and consistent standards can be reviewed.