花蓮地區長期照顧家庭主要照顧者時間貨幣價值之探討－－福康評估法之應用

Monetary valuation of primary family caregivers for long-term-care in Hualien: application of the Well-being Valuation Method

目標：了解花蓮地區長期照顧之家庭主要照顧者在維持現有整體生活感受下，多增加一個小時照顧時間之貨幣價值評估，並同時檢視影響其整體生活感受之因素。方法：利用福康評估法（Well-beingvaluationmethod），以花蓮地區長期照顧管理中心登記使用其中心所提供之各項相關服務個案之家庭主要照顧者為對象，面訪普查資料經刪除個案無主要照顧者或填答不完全之樣本後，共計833份有效樣本進行分析。結果：主要照顧者為男性、年齡較低、教育程度較低、罹患慢性疾病、照顧時間越長及每月收入越高與其自評整體生活品質感受為負向顯著關係。依受訪者實際填答之平均照顧時間及平均月收入計算，在維持其生活感受不變情況下，若多增加一個小時的照顧時間所需補償之金額約為138元；依勞基法所規定之最低薪資與基本工時做調整模擬後，所需補償的金額約175~245元。結論：本研究依勞基法原則估算家庭主要照顧者之貨幣價值，可提供未來我國長期照護保險制度規劃照顧津貼政策之參考。

Objectives: This paper estimates the monetary value of the loss of well-being by primary informal caregivers who provide long-term care to their family members. Taiwan is rapidly becoming an aging or even aged society. Authorities are planning to establish a long-term care insurance system which will provide both in-kind services (hospital or nursing home care) and cash benefits (subsidies to community or home care). Methods: We used the well-being valuation method to assess the monetary value necessary to maintain the same level of well-being when primary family caregivers are asked to provide an extra hour of care. Data from a survey on primary family caregivers of long-term care in Hualien were used for analyses. Results: Caregivers who were young and male with a low-level education, high income, chronic diseases, and who provided care of longer duration were negatively associated with the well-being of the primary family caregivers. The average number of hours of care per day was 10 hours. The results indicate that an extra hour of informal care is worth approximately NT 138. After adjustment by the Labor Standards Act, an extra hour of informal care is worth approximately NT 236~245. Conclusions: We conclude that the well-being valuation method is a useful complement to the more traditional valuation methods in the health economics literature in general, and more particular for the economic valuation of informal care. If care allowance is built into the long-term care insurance system, it would be necessary to pay the caregivers NT 236~245 for an extra hour of care.