影響住宿型長期照顧機構設置地點之因素

臺灣住宿型機構式照護設立分佈不平均，城鄉設立數差距大，且大多設立於人口多或醫療所附近，造成老人長期照護網的缺失及不足。本研究目的為瞭解臺灣住宿型長期照顧機構負責人選擇設立地點的考量因素以提供政府提供設立機構的誘因，以均衡住宿型長期照顧機構之地理分布以達到老人照顧網的完整性。本研究對象及方法以2016年衛生福利部合法登錄之1082家住宿型長期照顧機構資料其機構負責人為研究母群體，依機構所在地之鄉鎮排序後以系統抽樣法（Systematic Random Sampling）自0-9數字中抽取一號碼後每隔3號取一樣本，抽取1/3的機構共294家為研究樣本，以郵寄結構式自填問卷進行調查，共回收61份有效問卷，回收率為20.75%。以描述性統計分析機構負責人的特性、現有機構之優勢條件、對未來設置地點選擇考量等、並以邏輯斯迴歸探討影響因素。研究結果：住宿型機構式之執業資格以非醫事人員最高佔45.6％；機構權屬別以私立佔75.4％較高；開業地點權屬租賃最高佔50.9％。現有機構優勢以住民後送醫療便利性佳、取得設置地點成本低、所在地老年人口數量多為多數，比率分別為28.9、14.0、12.3；未來機構地點考慮因素以住民後送醫療便利性、所在地老年人口數量、取得設置地點成本為多數，比率分別為31.6、14.0、14.0；多數負責人認為長照政策會影響近三年設立長照機構意願比率佔78.9％，以邏輯斯迴歸探討影響因素發現取得設置地點成本是影響臺灣住宿型長期照顧機構之主要考慮因素。結論：後送醫療的便利性及取得設置地點成本是影響臺灣住宿型長期照顧機構之主要考慮因素，而長照政策是否補助或政策規劃與三年內再次設立機構與否有顯著性差異。

關鍵字

住宿型長期照顧機構；長期照顧；地理分布

並列摘要

The establishment of residential care facilities in Taiwan is not evenly distributed, resulting in the lack of long-term care networks for the elderly. The purpose of this study was to understand the factors of the choice of location for long-term care institutions in Taiwan to provide incentives for the government to provide establishments, and to improve the integrity of the elderly care network. This study object and method, a total of 1082 institutions were studied by using the database of long-term care institutions, that are legally registered in Taiwan. According to the institution’s place of registration by cities, counties, towns and villages, since a number 0-9 as present in extracts taken every 3, a total of 294 organizations were selected by system in a random sampling method. The questionnaires were send by mail and 61 effective questionnaires were collected. The recovery rate is 20.75%. Descriptive statistics was used to analyze the characteristics of the head of the institution, the factors affecting the location, the importance variables, and chi square test and regression analysis. Research result：The highest accreditation rate for residential institutions is 45.6% for non-medical personnel, 75.4% for private institutions, and 50.9% for property ownership leases. The advantages of the existing organization are: the convenience of medical care after the occupants; the low cost of obtaining the installation site; the majority of the elderly population in the locality; the ratios are 28.9, 14.0, and 12.3; The majority of the population and the cost of setting up locations were 31.6, 14.0, and 14.0. The majority of responsible persons believe that the long-term policy shadow accounted for 78.9% of the long-term institutions' willingness to establish long-term institutions in the past three years. Setting the location cost is a major consideration in the long-term care institutions in Taiwan. Conclusion: the convenience of evacuation of medical care and the cost of setting up locations are the major considerations affecting residential long-term care facilities in Taiwan, and there is a significant difference between the long-term policy whether subsidies or policy planning and the establishment of institutions again within three years.