臺灣「長期照顧十年計畫」日間照顧中心定價之研究

A Study of the Day-Care Center Price in Taiwan Ten-year Long-term Care Program

林品君(Pin-Chun Lin)

指導教授 ： 鄭清霞

國立中正大學/社會科學院/社會福利學系/碩士(2016年)

摘要

許多國家皆面臨人口老化的社會變遷，我國亦不例外。觀之政府為因應照顧需求增加，近年來持續推動與發展長期照顧服務，而日間照顧服務為當中一環，其相關法規以服務項目、人力配置、空間建築、設施設備等為主，對於定價的討論與要求較無明確之依歸，使目前服務提供者在服務的收費情況尚無一致性的作法與共識。

因此，本文旨在針對我國日間照顧中心之定價相關議題討論，研究目的有三：(一)分析台灣日間照顧中心之收費現況和定價模式；(二)呈現我國日間照顧中心的財務來源與成本結構；(三)探討適用於我國日間照顧中心定價的參考原則。

本研究主要採用深度訪談，並加入次級資料分析，結合質性與量化的方法收集相關資料，期待使研究內容更豐富。為能了解政府部門和服務提供者對服務與定價等相關議題的想像與看法，因此採立意取樣的方式，共邀請十位日間照顧中心主管人員與五位地方政府主管機關人員為訪談對象，並採取半結構式訪談，使資料蒐集過程兼顧研究架構，也能維持訪談內容的彈性和豐富。

結果發現：(一)我國日間照顧中心的收費標準呈現三種樣態，其一、服務使用者的失能程度別：區分為單一制定價模式與分級制定價模式；第二、日間照顧中心的服務對象類型：呈現失智型日間照顧中心的收費標準普遍偏高的現象；第三、區域別與收費標準差異：呈現從北而南，由高到低的情況。(二)上述三類之中，以失能程度別與收費標準是否互為影響的差異最為顯著，因而進一步分析單一制與分級制兩大模式對服務提供者、服務使用者和政府部門的影響，結果呈現兩種定價模式對服務提供者和服務提供者皆有利弊優缺，然就政府部門並無差異。(三)日間照顧中心定價的影響因素大致可分為：需求程度與付費意願、付費能力、市場價格、營運成本、國家政策五大層面。最後，依據本研究發現，提出對日間照顧中心定價之建議。

關鍵字

長期照顧 ； 日間照顧 ； 成本結構 ； 定價模式 ； 定價的影響因素

並列摘要

Many countries were facing the social change of population aging. Taiwan was included, too. Government has improved and developed long-term care services to respond for increasing needs of care. Day-care service is one of services. Government made regulations of day-care, including service items, staffing, space, and facilities etc., however, there is no standards for pricing. As a result, the charging standards of day-care center were inconsistent.

Therefore, the study focuses on the pricing of day-care center. There are three purposes of the research. First, analyze the charging standards and pricing models of day-care centers in Taiwan. Secondly, show finance and cost structure of day-care centers in Taiwan. Thirdly, find out the principle applies to pricing day-care centers in Taiwan.

In this study, methods of data collection are in-depth interviews and secondary qualitative studies. We also combine quantitative and qualitative methods in order to enrich the content. To understand the imagination and views of day-care center price, researcher chose purposive sampling and had been invited ten executive officers and five local government authority staffs. Researcher used semi-structured interviews to focus on research framework to enrich flexibility and the content of the interview.

The results of the study are as follows：First, the charging standards of day-care centers in Taiwan could be separated into three states. One is that whether the charging standards could distinguish different degrees of disability between models of single price and rating price; another is that different types of day-care center have different charging standards; according to the study, the single price in dementia day-care center is higher than others. The other is regional variation. We could find the price is getting lower from northern to southern in Taiwan. Secondly, as three states mentioned above, the effect of charging standards and degree of disability show the most significant deviation. Therefore, we analyzes the effects of models of single price and rating price for service providers, consumers, and governments. The results show that both of those two pricing models have strength and weakness for service providers and consumers. Thirdly, the causes of day-care center price could be divided into five categories：needs and willingness-to-pay, ability-to-pay, market price, cost, and policy. The study provides recommendations for the future day-care center development policy.

並列關鍵字

long-term care ； day-care ； cost structure ； pricing model ； influential factors

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