機構式長期照護需求之影響因素及建構長期照護體系之雛議

周韋詩

doi:10.6342/NTU.2006.03135

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機構式長期照護需求之影響因素及建構長期照護體系之雛議

Factors Affecting the Demand for Institutional Long Term Care and a Model for the Long Term Care System

周韋詩 , Ph.D　　Advisor：周治邦;胡勝正　　

繁體中文 DOI： 10.6342/NTU.2006.03135

機構式長期照護；意願需求；經濟支持；中高齡者；長期照護體系與政策；長期照護保險；高齡局；醫護之家；次網絡； Institutional long term care ； Notional demand ； Financial support ； Middle and old aged ； Long-term care system and policy ； Long-term care insurance ； Elderly Bureau ； Medical-Nursing House ； Sub-network

Abstract │ Reference (310) │ Times Cited (4) │ Altmetrics

Abstract 〈TOP〉

Parallel Abstract 〈TOP〉

First, this study investigates the determinants of the notional demand of institutional long term care of middle and old aged people. In particular, this study examines whether financial support is one of significant factors. From a national investigation in 1999, we choose those who are over 50 years old with the total number 3,182. This study uses logit model to analyze the effects of financial support、characteristics、 health status、caring human resources and attitude factors on the notional demand of long term care. When we employ financial support factors, we obtain the following significant factors: whether the interviewees have jobs、saving beforehand for the elderly life、 area、 whether receiving care when sick and the attitude. Without financial support factors, we obtain the following significant factors: area、marriage status and whether receiving care when sick. From investigation in 1999, area and dependence are stable significant factors no matter whether we employ financial support factors or not. By Likelihood Ratio test, we can know that the financial support factors significantly affect those 50 to 64 years old people. However, for those above aged 65, by likelihood ratio test of other variables, we find that caring human resources factors significantly increase the explanatory power of the regression. Therefore, our government should establish long term care policy aiming at different age groups.

Next, we discuss the health care system and policy for the elderly in Japan and Taiwan, including long-term care insurance in Japan、the advantages and disadvantages of the long-term care system and future reform. Japan has become an aged society since 1970, when the rate of the 65+ population was up to 7%. In 1995, the aged population rate was already up to 14%, which means it only took Japan 25 years to double the rate. Japan has experienced quite rapid progress in population aging. Moreover, Japan has the longest life expectancy in the world now. Under the condition of rapid aging and diminishing family care resources, the construction of the long-term care system and policy is really important. After discussing Japan’s long term care system, we review Taiwan’s long term care system. By observing Japan’s system, we refer to some policy implications.
  
  Finally, according to the discussion about the health care system and policy for the elderly in Japan and Taiwan, we establish a health care system of Taipei elderly, including both mental and physical health, which ensures the rights and interests of the elderly. In addition, we hope Taipei can become the model city of the elderly, and other cities can learn much from Taipei. From the past, current and future elderly policy in Taipei, we can know both health and social sectors have the design and management rights. Therefor, we suggest establishing an “Elderly Bureau” to unify the implementation of the policy and the allotment of the resources. Besides, we divide Taipei into 4 sub-networks, and construct the ideal care system orderly, including income protection, medical care provision, housing arrangement, community care service and promotion of the living satisfaction.  The most important is the establishment of “Medical-Nursing House”, providing the comprehensive care for the elderly. At last, a whole day and night elderly helping center network is established. However, the further detail planning needs to be researched in the future.

Reference ( 310 ) 〈TOP〉

王文宇、李淑容、楊培珊(2005a)。台北市老人及身心障礙者財產信託制度之
連結：
王文宇、李淑容、楊培珊(2005b)。台北市老人及身心障礙者財產信託制度之
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王宛茹(1998)。台灣地區老人安養供需之研究。國立臺灣大學社會學研究所碩
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李世代(2002a)。長期照護之概說。當代醫學，1，60-69。
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李怡娟(1997)。城鄉社區老人使用居家護理服務情形及其預測因子之探討。護
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Times Cited (4) 〈TOP〉

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