醫務社工的經濟補助服務之發展與變遷：以某醫學中心為例

The Development and Changes of Medical Social Workers' Economic Subsidies Services: An Example of a Medical Center

本研究以描述統計，分析某醫學中心自2010至2014年的經濟補助支出情形，包括支出項目、比例、人次等的變化，以瞭解近5年經濟補助內容的轉變；其次，以焦點團體的方式訪談5年以上資深社工師，探討影響轉變的因素。在量化資料上，我們發現接受補助的病人性別以男性居多；住院醫療費用補助比例以50％～74％為最多；在補助項目上，醫療費用與照顧費用為最大宗的補助項目，兩者間的補助佔全部補助金額的比例在2010至2013年呈現醫療費用逐年下降、照顧費用上升之趨勢。至2014年，醫療費用的補助比例略微回升；反之，照顧費用比例略微下降。綜合以上量化資料及質化訪談內容之分析，我們由政策環境的影響、家庭型態轉變、醫院組織文化及社會工作師的角色等四大面向進行論述，呈現出經濟補助業務的實況以及對社工專業的省思，並提出對醫務社工角色內涵的實務觀察結果。

In order to understand the changes in medical subsidies of the medical center in the past 5 years, the study first use descriptive statistics to analyze the expenses of medical subsidies from 2010 to 2014, including items, proportions and person-times. Secondly, we use a focus group to interview senior social workers who have more than five year working experiences to explore the factors that affect the changes. According to the quantitative data, we found that our major recipients are male. Most of the proportion of inpatient medical subsidies is between 50% and 74%. The first two items of subsidies are medical fees and care costs. There was a downward trend in the proportion of medical fee while the care costs increased from 2010 to 2013. In 2014, the proportion of medical fees was slightly upward while the proportion of care costs mildly declined. By analyzing the outcomes of the quantitative data and qualitative interviews, four aspects were discussed in the study: influence of policies in the macro environments, transformation of family types, organizational culture of the hospital and the roles of social workers. We present the practical situation of economical subsidies and reflection on the social work profession. Finally, we bring forward the results of practical observations in the context of medical social workers' roles.