建構以偏好為基礎之老人居家照顧服務傳遞系統－健康照護價值鏈觀點

Constructing a preference-based demand-response home care service delivery system for the elderly: From the perspective of a health care delivery value chain

周瑛琪(Y.-C. Chou) ； 盧慶樺(C.-H. Lu) ； 顏炘怡(S.-Y. Yan) ； 唐明順(M.-S. Tang)

《福祉科技與服務管理學刊》 2卷3期 (2014/08) Pp. 183-190

https://doi.org/10.6283/JOCSG.2014.2.3.183

摘要

有鑑於高齡化社會的來臨，長期照顧需求人口數劇增，老人之相關福利受到政府及民間單位的高度重視，內政部擬定長期照顧十年計畫，規劃於10年內挹注新台幣817.36億元經費建構長期照顧制度，使長期照顧服務產業蓬勃發展，其中「居家照顧服務」為長期照護服務的重點工作，亦為社區式服務中最基礎的照顧模式。但是目前居家照顧服務尚未建立周延的人力規劃模式及服務傳遞系統，致使出現人力負擔過重及服務傳遞效率不彰等問題。因此本研究運用多目標規劃模型，設計居家照顧服務員之排班模型，特別考量服務過程中需求端及供給端的變異，例如案主及居家服務員的偏好、特質、及各項突發狀況。另一方面，由於社福機構為社會捐贈物資的平台，於居家照顧服務的時機發放物資給弱勢家庭，但是目前社福機構缺乏物資管理系統，致使物資可能重覆發放或是過期報廢。加上案主亦有代購物資及輔具等需求，有鑑於此，在第一年及第二年的排班及物資需求等系統建立後，第三年便發展物資資料庫管理系統，促使社福機構發展聯合採購的創新服務，使其健康照護價值鏈更加完備，並可妥善發揮居家照顧服務的效能及效率，提高居家服務品質。

關鍵字

健康照護價值鏈 ； 社會福利系統 ； 服務系統設計 ； 老人居家服務 ； 排班 ； 偏好

並列摘要

Given the advent of an aging society and the long-term care needs of the surging population, related welfare benefits for the elderly by government and private organizations place great importance on the Ministry of Interior to develop a long-term care plan, with the injection of NT 81.736 billion in funds to construct a long-term care system, so that the care industry can flourish, and long-term focus on home care services and community-based services are part of the most basic care model. However, the current home care services have not fully established the human resource planning model or the service delivery system, resulting in an excessive burden on human resources and inefficient service delivery. Therefore, this study uses the Multi-Objective Programming Model, to design a home care attendant scheduling model, particularly focusing on the service process and the demand side of the supply-side variability. For example: cases of health care clients and social worker preferences, characteristics, and various unexpected situations. On the other hand, due to social welfare organizations as platform donations, home care services are able to distribute aid to disadvantaged families. However, due to not having a current established social welfare agency materials management system, there are problems of over distribution and obsolescence. Additionally health care clients had other needs; such as, help to purchase materials and assistive devices for scheduling and material requirements in the first and second year. In view of this, the third year of the development of materials database management system has focused on the development of social welfare institutions for joint procurement of innovative services to make the health care value chain more complete, increase effectiveness and efficiency of home care services, and improve the quality of home care services.

並列關鍵字

health care delivery value chain ； social welfare system ； service system design ； home service for the elderly ； scheduling ； preference