大台南地區小型老人養護機構服務品質之探討

The Service Quality of Small-Scale Elder Long-Term Care Organization in Tainan City

童佳琪(Tung, Chiachi)

指導教授 ： 鄭讚源

國立中正大學/社會科學院/社會福利學系/碩士(2012年)

摘要

台灣自西元1993年起便邁入了高齡化社會，65歲以上老人所占比例持續攀升，至2012年六月底底，老年人口佔總人口的比例已達10.98％，而衛生署估計到了2025年，65歲以上老年人口將占總人口的20%，台灣將成為「超高齡社會」，對政府的社會福利和健康政策，都將形成一大挑戰。針對家庭照顧功能較為不足之高齡人口提供機構式照顧，是以免辦財團法人登記、不對外募捐、接受補助或享受租稅減免之小型老人養護機構佔最多，且符合我國長期照顧政策中「在地老化」（aging in place）之目標。
但在研究者本身觀察參與以及社會事件中，卻發現小型老人養護機構品質參差不齊，虐待、忽略或專業人員人數不足等事件層出不窮。有鑒於此，本研究利用台南縣市99年度小型老人養護機構評鑑資料，探討小型老人養護機構之服務品質影響因素。故本研究之研究目的有三：一、瞭解大台南市小型養護機構之現況；二、探討大台南市小型養護機構的主管、組織、環境特質與服務品質之相關性；三、根據研究結果提供給小型老人養護機構經營者具體建議，以改善機構服務品質。
　　經由文獻探討與資料分析後，本研究發現：一、台南縣市平均佔床率為81.57%，與以往的研究相高出許多，顯示我國老化指數每年逐漸上升，有養護需求的老人也逐漸增加；二、在依變項分析之描述性統計方面，發現以服務品質模型中之環境設施與安全維護平均分數為最高，標準差也最小，顯示在96年老人福利機構設立標準修法後，機構的硬體設施與消防設備多能符合法規規定。而服務品質模型中之改進創新平均分數為最低，標準差也最大，顯示機構在此方面表現參差不齊，有很大的改進空間；三、經統計分析，影響台南縣市小型老人養護機構服務品質之因素有收容規模、專職比、財務資源與機構空間等，均對服務品質有正向影響。
因此本研究建議：一、將「老人福利機構設立標準」中對於收容規模與機構空間之規定均提高，以達到經濟規模，增進機構的服務品質；二、明定評鑑指標之細則，讓機構有可依循之準備方向；三、留意城鄉差距所帶來的資源不平等；四、建議機構能聘請足夠且符合法令規定之護理人員與照顧服務員，提高專職比對於小型老人養護機構服務品質具有正面影響力。

關鍵字：小型老人養護機構、服務品質

關鍵字

小型老人養護機構 ； 服務品質

並列摘要

Abstract

Since 1993, Taiwan has turned into an aging society; over 65 aged elders proportion continues to rise. At the end of 2010, the percentage of the elderly population to total population reached 10.74%.The department of Health estimated that over 65 aged elders will occupy 20 percent of total population in 2025 which makes Taiwan become ”an aged society”. It becomes a huge challenge to government's social welfares and health policies. Providing institutional cares that aimed at elders with family care functions insufficient was mainly no registration of foundation, no external fundraising, no subsidy accepted and no tax reduced institutions which was in line with our long-term care policy goal “aging in place”.
However, reseachers found that the quality of small-scale elderly care organizations is uneven in social events; abuse, neglect or lack of professionals kept emerging. Thus, this research uses the 99th year’s evaluation data of small-scale elderly long-term care organizations in Tainan to discuss the factors that influence on service quality of small-scale elder long-term care organizations. The purposes of this study are three. First, understand the current status of Tainan city small-scale elder long-term care organization; second, discuss the correlations among institution’s manager, institutions, environmental characteristics, service quality of small-scale elderly long-term care organizations in Tainan. Third, provide concete advices based on the survey’s results for small-scale elderly long-term care organizations in order to promote service quality.
By reviewing literatures and analying data, we found. First of all, the average occupies the bed rate is up to 81.57 percent which is much higher than the former study, indicating the aging index of our country is gradually increasing each year. Also, the elders who need caring is increasing. Second, in the descriptive statistics of variables aspect, we found that environmental facilities and maintenance security average score is the highest and the standard deviation is the smallest in the model of service quality. This indicated that after the amendment of Establishment Standards of Senior Citizens’ Welfare Institutions in 2007, most of the snstitutions’ facilities and fire-fighting equipments are legal. Improvement and innovation average score is the lowest and the standard deviation is highest in model of service quality, showing that the organizations’ performance are uneven adn have a lot of rooms for improvement. Third, by analyzing statistics, the factors that influence small-scale elderly long-term care organizations are shelter scale, full-time rate, financial resources and institution’s space which is positive to service quality.
Thus, we advice. First, “Establishment Standards of Senior Citizens’ Welfare Institutions” shelter scale and institution’s space were increased in order to achieve economies scale and enhance the organization's service quality. Second, explicitly explain evaluation index details so that organizations can follow the directions to prepare. Third, pay attention to the gap between urban and rural areas of resource inequality. Forth, suggest hiring enough legal nurses and care givers, improving full-time rate which have positive influences on small-scale elderly long-term care organizations service quality.

Key word：small-scale elder long-term care organization、service quality

並列關鍵字

small-scale elder long-term care organization ； service quality

參考文獻

吳卓夫、林琪培、紀慧禎(2003)。雪霸國家公園服務品質滿意度之研究。內政部

李光玉、曾明朗(2008)。嘉義地區老人安養機構服務品質評鑑準則之因果決策研

林素鈺(2004)。服務品質模式之演變。《品質月刊》，40，頁68-74。

林慈恩、李鴻文(2007)。從資源基礎理論探討長期照護機構之競爭優勢。《運動

桂楚華、林清河(2008)。。全面品質管理與六標準差。台北市：華泰。