- 學位論文
政府評鑑下鄉村地區小型老人養護機構與派遣聘雇專業社會工作員之互動及圖像
The Interaction and Mapping of Dispatched Professional Social Worker’s Role in Small Scale Care Facilities in Rural Taiwan under Government’s Evaluation Requirement
摘要
研究目的：探索小型老人養護機構與派遣公司兩者互動與專業社工員經驗與圖像及小型老人養護機構對於政府評鑑管制的想法與感受，了解使用派遣專業人力的原因，並且探究派遣專業社工員在如何實施服務過程，服務實施的過程是否能真正提升服務品質呢？ 研究發現：機構藉由與商業公司結盟聯合方式規避應盡之責任，專業社工在執行服務責任使命與機構忠誠之間處境尷尬。政府運用機構評鑑意圖確保及提升照顧品質，但是往往無法落實真正的監督管理。流於書面制式化審查及評鑑方式，使得監督服務的失真，有違評鑑期望達成的目標有違。 派遣社工員運用專業知識技能回應政府評鑑，被小型機構視為重要工具與方法，並不被機構視為專業的資產與人力，專業社工員期望實際服務與派遣公司目標仍有差距與衝突，使得社工員難以在小型機構中展現專業方法提供服務。 政府期望以評鑑方式維持服務品質，但實際上，需要服務的老人仍然需要面對小型老人養護機構經由篩選，在小型老人養護機構成本考量下，公費老人與一般非公費老人相較，機構較不偏好收容公費老人，弱勢使用者(需要服務之老人)在準市場的邏輯法則中被淘汰。 研究結論，政府對小型老人養護機構的管制與評鑑制度，在商品化市場的運作邏輯之下，小型老人養護機構，經由派遣方式，與商業公司結合，採取成本考量，降低人事支出。同時在提高機構營利考量下，透過內部篩選方式，讓弱勢需要服務的高齡者，面臨無法入住使用服務的現況。政府的評鑑指標，亦無法真正反映機構真實的服務現況及品質。 關鍵詞：小型老人養護機構、新公共管理主義、評鑑商品化、派遣社工、服務品質
並列摘要
Research purposes: To explore the interaction of small scale long-term care facilities in rural Taiwan and its relationship with dispatch company. To analyze and mapping the professional training social workers’ role and their dispatched experience. The theoretical question is whether the quality of service would raise under government’s supervision and evaluation process. Dispatch social workers not only have to function as institutional reaction and respond to government regulation, but also being considered as an important tool for small scale care facilities as an organizations’ way of avoiding quality control. Dispatched social workers have not been treated by employer as professional asset but rather a means to respond to governmental regulation. There existed a huge gap between the institution expectation and dispatch company's goals. Government expects to use periodical evaluation to maintain and promote quality of service in small scale care facilities; but in fact, elderly people in need of services still face screening process, since the service provider would choice easy case to provide service such as creamy effect. Under cost containment of small scale long-term care facilities, elderly people with the public aids would have better chance to gain service compare to those who have to pay out of their own expense. Conclusions: The government’s wishful thinking of using regulation and evaluation system to promote the service quality of small scale service agency which provides service to elderly people proved to be not effective as it supposed to be. The dispatched company, the small scale agency and professional social worker that they all became parts of the game under the name of neoliberalism’s cost efficiency control under which none of them win. The commercialized of evaluation process has made the condition getting worse for those elderly people who needs service. Key Word: small scale care facilities, new public management, commercialization of evaluation, dispatch social worker, quality of service