公立老人安養機構經營管理之探討──行政管理者的觀點

A Study of the Management and Operation for Public Elder Care Homes: The Perspective of Administrative Managers

葉昭宏(Chao-Hung Yeh)

指導教授 ： 孫健忠

國立臺北大學/社會科學學院/社會工作學系/碩士(2012年)

摘要

本研究從公立老人安養機構行政管理者的實務經驗與角度出發，去呈現機構提供公費照顧服務的現況，以及出現在經營與管理層面的問題，並探討其所面對的困境與因應策略，期能提供適切的建議，以供管理者與實務工作者作為能夠持續有效工作的參考。

本論文採取質性研究取向，以國內非營利組織的管理經驗發展而成的「CORPS」模式作為主要研究架構，兼採其他機構管理相關文獻，將影響公立老人安養機構經營管理問題的因素區分為機構「內部」的因素，以及機構「外部」的環境因素，並結合實證經驗與預訪的修正意見發展訪談大綱，於國內十四家公立老人安養機構當中選定三家具代表性且分屬不同政府單位的機構作為研究場域，以其中七位具有相當資歷的機構管理者為研究對象進行深度訪談，以了解受訪者在執行公費安養業務時的豐富經驗。

研究結果將目前公立老人安養機構在經營及管理上的主要議題歸納為五大部份，分別是：
一、無法自行掌控的未來發展：由於人事、經費皆受限於上級機關，讓機構在面臨法規修正、環境變化、社會期待等各方面的挑戰時，無法依照機構的最大利益作出決策。
二、沉重的政府照顧責任：機構基於政府的照顧責任無法選擇進住的個案，也因此項義務而無法對於問題個案做有效的處理，導致機構安全、住民生活受到影響，以及公立機構照顧成本提高等問題。
三、社會工作專業發展不足：由於公立安養機構社工人員的晉用是以考試分發為主，無法考量人力的專業背景，再加上機構人員的流動率高，經驗難以累積，社會工作專業無由發展。
四、照顧服務人力的優勢與困境：機構原具有能夠提升服務品質的穩定照顧人力，但在政府的人事精簡政策與法規對照顧人力要求提高的交互作用下，公立老人安養機構反而面臨人力不足的窘境。
五、志願服務運用成效不佳：慣於運用外界志工團體的模式對於許多受訪者造成相當的困擾，但在機構偏遠又缺乏對社區互動經營等因素影響下，機構多無法招募到足夠的人力成立本身的志工團隊，協助達成機構的目標。

關鍵字

公立老人安養機構 ； 經營管理 ； CORPS模式

並列摘要

The purpose of this research is providing appropriate advice for the manager and eldercare services provider in order to sustain and work effectively. In our research, we will present the state of eldercare at public expense under the point and experiences of both public and private eldercare institutional manager. These will show up the problems in conducting and managing the institutions. We will discuss the operating dilemma and the strategies to deal with.

The method of our research is under the base of quality index. The framework of our research is according to the “CORPS” model that developed from the manager experiences of domestic non-commercial institution. We will also consult the documents of other organizations. The factors that affect the manage of public elder care homes will be separated as “internal” and “external” circumstance problems. We will expand an interview outline according to evidence base experiences and revised opinions of preview. The field of our research including the 14 public elder care homes in our country. 3 of these institutions will be selected because of belonging to different government units. 7 senior managers will accept interview to find out how to execute eldercare of government expense affairs.

The results about conducting and managing the present public elder care homess were separated as 5 parts:

1.Uncontrolled future: in spite of the challenges from all respects including legislation revising, environment change or community desires; under the restrictions of personnel matters and budgets that controlled by higher authorities, the most beneficial policy can not be made.

2.Leaden responsibility for government to take care of: the calling of the government is taking care of people, so the institution may not be able to choose case which may join in. therefore the problem case will not be dealt appropriately. The security of institution, the life of residents and the cost to take care will consequently influenced.

3.Underdeveloped social work discipline: the assignments of public nursing care unit were determined mostly by test. The professional background will not be considered. Furthermore, highly floating rate of staffs lead to dissipate experience and undeveloped social work discipline.

4.The advantage and disadvantage of care service manpower: the institution got enough manpower for promoting care quality at first. Unfortunately, under the interaction of organization trimming and ordinances to ask for more manpower, the public elderly care center encounter the plight of insufficient manpower

5.Ineffective voluntary service use: many visitors were used to external voluntary group and they suffered from relying on this mode. However, the institution will not be able to recruit enough manpower to join internal voluntary unit especially when the place is faraway and lack of interaction with community. Hence the goal of the institution will not be achieved.

並列關鍵字

blic Elder Care Homes ； Management and Operation ； CORPS model

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