目標:估算我國居家失能老人之外籍監護工使用率,並檢驗使用之相關因素,方法:以居家1.379位失能老人的調查資料為分析資料,評估其在過去一年中之外籍監護工使用率,並以Andersen Behavioral Model為分析架構,利用邏輯斯複迴歸統計方法檢驗是否使用外籍監護工之相關因素。結果:過去一年中居家失能老人之外籍監護工使用率為15.2%。控制其他變項後,使用率顯著較高者包含:女性(勝算比為2.28, 95%CI=1.47-3.53)、教育程度越高者(勝算比為2.03, 95%CI=1.15-3.56)、家戶每人每月平均收入越高者(勝算比為1.71, 95%CI=1.07-2.72)、與子女同住者(勝算比為4.88, 95%CI=2.74-8.72)、知道居家服務者(勝算比為1.90, 95% CI=1.31-2.75)、家庭主要照顧者為媳婦者(勝算比為1.64, 95% CI=1.02-2.63);家庭主要照顧者有專職工作者(勝算比為 1.93 ,95% CI= 1. 25-2.98)、住在三鶯地區者(勝算比為1.98, 95% CI=1.35-2.89)、身體功能重度障礙者(勝算比為11.90, 95 % CI=6.29-22.52)、診斷疾病數多者(勝算比為1.10, 95% CI=1.02-1.19)。結論:居家重度障礙者、專職就業的家庭照顧者使用率高,顯見其對外來人力協助的需求;高教育、高收入者外籍監護工使用率高,未來嬰兒潮人口即將老化,其教育程度及收入大幅改善,可能會導致外籍監護工使用率大幅提升,但國家政策又以降低外籍監護工人數為目標,兩者之問的矛盾政府應及早尋求對策,滿足其照顧需求,否則將難達到政策目標。
Objectives: To determine the utilization of hiring a foreign care aide for the disabled elderly in the community and to understand the factors associated with such utilization, Methods: Data pertaining to 1,379 disabled over 65 years of age was collected in a baseline survey of 2 experimental communities selected for the Pilot Program for Long-Term Care Development. The Andersen Behavioral Model was used to examine the factors associated with hiring a foreign care aide in the past year among the disabled elderly. Results: Approximately 15.2% of the disabled elderly hired a foreign care aide in the past year. Multiple logistic regression showed that after controlling for other variables, those who hired a foreign care aide were likely to have the following attributes: female gender (OR=2.28, 95%CI=1.47-3.53), at least a secondary education (OR=2.03, 95%CI=l.l5-3.56), higher income (OR=l.7l, 95%CI=l.07-2.72), living with children (OR=4.88, 95%CI=2.74-8.74). living in the San-Yin area (OR=l.98, 95%CI=l.35-2.89), awareness of home care (OR=l.90, 95%CI=l.3l-2.75), living with a daughter-in-law as the caregiver (OR=l.64, 95%CI=l.02-2.63), a caregiver who works full-time(OR=l.93,95%CI=l.25-2.98), more ADL disability (OR=11.90, 95%CI=6.29-22.52), and wore diagnosed diseases (OR=1.10, 95%Cl=1.02-1.19). Conclusions: Elderly who are moderately-to-severely disabled and whose caregiver has full-time work have a higher utilization of foreign care aide. This implies that the disabled elderly need more extra-family assistance of care. Moreover, the disabled with higher education and income are more likely to hire a foreign care aide, suggesting that policy should focus on the coming trend that baby boomers will have a higher education and income. With the goal of decreasing the number of foreign care aides in Taiwan, the government should develop appropriate services in response to the needs of the disabled elderly and their family.