臺北市老人長期照顧政策之研究：跨域治理觀點

The Study of the Taipei City Government’s Long Term Care Policies for the Elderly: the concept of across boundary governance

吳美珠(Mei-Chu Wu)

指導教授 ： 丘昌泰

國立臺北大學/公共事務學院/公共行政暨政策學系/碩士(2011年)

摘要

因應高齡化社會之趨勢，老人長期照顧需求快速增加及問題的複雜性，本研究以網絡觀點下的跨域治理概念做為出發，針對臺北市的老人長期照顧政策進行深入觀察，探討執行過程中產生的相關問題與困境，並對政府所規劃之各項政策方案進行檢視，希望透過研究能進一步探究問題，找出問題成因，使我國長期照顧能符合利害關係人的需求，達到政策目標。
全文分為五章，第一章說明研究動機、目的、相關概念界定、文獻探討及範圍；第二章為臺北市老人長期照顧政策之形成背景與現況分析；第三章為跨域治理及老人長期照顧模式理論探討，並根據理論基礎建立本研究架構及訪談設計；第四章將透過與跨域網絡的相關行動者及利害關係人訪談結果做出分析與歸納，找出相關影響老人長期照顧的原因；第五章為研究發現，以及對理論的反省，最後提出建議與結論。
本研究發現，居家照顧服務的可近性、方便性，人員的態度均能有效提升服務的使用量並提高老人的安全感，而社區照顧提供老人照顧及民眾盡孝道又可喘息的照顧模式，也是民眾訊息重要的來源管道及支持系統，另對於無法照顧或需專業照顧人力，機構提供老人24小時的全天侯照顧。但除了照顧模式的優缺點外，另中央及地方府際互動及跨部門合作應再強化、網絡關係中的利害關係人服務行銷及使用項目不夠多元、跨域治理網絡資源的整合尚需加強、長期照顧管理中心的單一窗口功能有限及服務整合不足、直接照顧服務人員及其他專業人員不足、工作保障低、無障礙設施設備不足及相關服務動線不流暢等問題尚需加強。
最後，針對上述研究發現，提出成立長照跨域治理委員會，建構老人長照網絡體系、整合長期照顧網絡資源及政府各部門、長照管理中心功能擴展提供網絡平台、專業人員的提升、無障礙改善、緊急救援系統科技普及化、服務的多元可近性、小型機構的處理因應、資源的整合行銷等政策建議。

關鍵字

跨域治理、長期照顧模式、網絡、多元互動、非營利組織

並列摘要

Caring for the elderly in a long term in this aging society presents a great challenge. This study takes a holistic view, based on the concept of across boundary governance, to investigate the Taipei City Government’s long-term care for the elderly, and discuss the problems and possible solutions in the course of the implementation of these policies. All aspects of government’s policies are examined; therefore the causes of the problems can be identified. By doing so, we hope to make an improvement for the long-term care policy for the elderly and meet the goal the government aspires to.
This study is divided in to five chapters. The first chapter expounds on the aims, purpose, definitions of terms, literature review and the limitation of this study. Chapter two analyses the historical background and the current development of Taipei City Government’s long-term care policies for the elderly. Chapter three discusses the theory of across boundary governance and the long-term care for the elderly, and formulates the structure of this study and the design of interview. Chapter four has made the analyses and syntheses based on the results of the interviews of the across boundary activists and those who are concerned in this study, so as to identify the related factors for the long-term care policies for the elderly. Chapter 5 elaborates on the findings, the reflections of the theory, and makes the suggestions and conclusions.
The study found that the effects of the residential care services for the elderly would be improved and more accessible with the improvement of its closeness, convenience, and service. The elderly can get a great sense of security from that. The community care provides a care model for the elderly. The community care can also serve as the place for the public to pay their filial piety and as the place for them to get some new information and family support. In addition, for those who do not have or need professional care, this institution also provides 24 hours care for the elderly.
Except from the pros and cons of the care model, the local and central governments’ interaction and trans-department cooperation should be enhanced. The service and marketing and the items provided from those who are concerned in this care system should be more plural. The resources of the network of the across boundary governance should be integrated more tightly. The function and service of the single window for the long-term care for the elderly is not efficient enough. There is a lack in the direct care personnel and other professional personnel. The poor job security, the lack of accessible equipments and complete service package should be overcome.
In conclusion, based on the findings above, we would like provide the solutions by setting up the long-term and across boundary care committee and integrate the network of the long term care system. The network of the long term care system should be integrated with different government departments. The functions of the long term care management center should be expanded and the network should be provided. The professional training for the personnel and the improvement of the accessible equipments are in urgent need. The popularization of the emergency rescue systems and the accessibility and plurality of the service should be enhanced. The problem-solving schemes of the small institutions and the integration and marketing of different resources should be made.

並列關鍵字

across boundary governance, long term care model, network, multiple interaction, NGO

參考文獻

丘昌泰，2000，《公共管理－理論與實務手冊》，台北市：元照出版公司。

王品喬，2008，《家庭女性照顧者需求之探討：以高雄市長期照顧管理中心為例

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