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我國長照政策之發展趨勢及對護理專業的影響

The Development of Long-Term Care Policies and the Impact on Nursing

摘要


台灣面對高齡、少子女、少勞動力的人口趨勢,政府除發展社區活躍老化政策,須同時強化醫療照護與長期照護(長照)體系的運作。全民健保要永續經營,需改革支付制度,急性後期照護會朝以居家及社區為主、住院式為輔發展;長期照護服務法的通過將整合分散在各法的長照服務單位、設置長照發展基金、結合長照服務網、獎補助長照資源不足社區發展長照資源、改善長照服務品質與分布;長期照護保險法的規劃,支付制度將採包裹式支付以協助失能家庭;長照服務之提供需強化資源整合與效率提升;長照業務資訊化與雲端整合,將使長照體系運作更透明有效率。護理人員較其他社區專業人員更擅長老年照護與諮詢,但仍較缺乏經營與管理培訓;未來居家與社區式照護需更多優秀人力投入,將增加護理人員創業或彈性工作契機;護理人員需強化急性後期照護、獨立創業、經營管理及專業合作協調等能力,以掌握護理專業在長照領域發展之契機。

並列摘要


The government must reform and enhance current medical and long-term care services in order to respond effectively to societal ageing and labor shortage trends and to ensure sustainable operations. The post-acute care system should be reoriented on the home and community instead of the hospital. The Long Term Care Service Act integrates long-term care services that were previously dispersed amongst different departments, sets up a long-term care development fund, and improves the quality and allocation of long-term care services. Moreover, the Long Term Care Insurance Act will implement a bundle payment system to assist disabled families. The integration of automation and information technology will make long-term care more efficient. Although nurses are more skilled at elderly care and counseling than other community care professionals, nurses generally lack training in business management. Home and community-based services thus require better-trained manpower, opportunities to set care agents, and opportunities to offer flexible caring jobs. Therefore, nurses should strengthen their capabilities in post-acute care, business management, cooperation, and coordination.

參考文獻


李玉春、黃昱瞳、黃光華、葉玲玲、陳珮青(2014).全民健保支付制度改革之回顧與展望.台灣醫學,18(1),53–66。[Lee, Y. C., Huang, Y. T., Huang, K. H., Yeh, L. L., & Chen, P. C. (2014). The review and prospect of the national health insurance payment system reform. Formosan Journal of Medicine, 18(1), 53–66.]
吳肖琪、黃姝慈、吳秋芬(2014).美國住院與急性後期照護之包裹式支付制度.台灣公共衛生雜誌,33(5),459–469。[Wu, S. C., Huang, S. T., & Wu, C. F. (2014). Bundled payments for inpatient and post-acute care services in the United States. Taiwan Journal of Public Health, 33(5), 459–469.]
鄭守夏(2011).全民健保向論人支付邁進.台灣公共衛生雜誌,30(1),1–4。[Cheng, S. H. (2011). Developing the NHI capitated payment system. Taiwan Journal of Public Health, 30(1), 1–4.]
American Nurses Association. (2012). The value of nursing care coordination- A white paper of the American nurses association. Retrieved from http://www.nursingworld.org/carecoordinationwhitepaper
Buntin, M. B. (2007). Access to postacute rehabilitation. Archives of Physical Medicine and Rehabilitation, 88(11), 1488–1493.

被引用紀錄


石靜霓(2022)。日間照顧中心照顧團隊運作經驗探討-以南投縣為例〔碩士論文,國立暨南國際大學〕。華藝線上圖書館。https://doi.org/10.6837/ncnu202200315
陳儀倩(2018)。居家醫療整合照護模式新契機彰化護理25(3),5-11。https://doi.org/10.6647/CN.201809_25(3).0003
林欽裕、邱琬育、郭年真、陳定紘、杜裕康、陳雅美(2023)。居家護理資訊系統使用者使用意願研究長期照護雜誌26(2),119-137。https://doi.org/10.6317/LTC.202312_26(2).0001

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