長照政策量能提升的政府策略性作為之探討──以臺中市政府為例

Strategies of Enhancing Capacity of Long-term Care Policy by Government: A Case Study of Taichung City Government

回顧長照十年計畫自2007年推動近十年的努力，卻讓臺灣的外籍看護工快速增長，臺灣自行發展的長照服務卻相當薄弱，深度探討有二個現象應是關鍵：一、長照政策的核心價值的定位不明確。二、長照服務發展缺乏「區域深耕」之思維。如何有效促進更多長照服務提供單位的投入，並引導區域發展的深耕，整合提升長照量能，以臺中市政府為例，目前策略性作為有：一、高齡業務及組織的整併。二、以鄉鎮市區為服務劃分區域的主要依據。三、推動特約式的委託關係。四、推動整合支付評估及服務。各項提升長照量能的具體措施應為中央與地方共同合作，方能有充份空間來進行各項的測試，所實驗的成果方能客觀、務實可行，未來全國推動時，才不會因未經過深度的試辦，無法建立良善的政策執行力。長照2.0即將上路，建議中央應與地方緊密合作，共同研發，透過健全合理的支付制度翻轉臺灣長照的困境，有效促進長照服務的發展，因應臺灣快速老化帶來的嚴峻衝擊。

By reviewing 'Ten-Year Plan for Long-Term Care' in the last decade, relative to growing rapidly of foreign care workers in Taiwan, its own development of long-term care service is poor performance. There should be two key reasons: The positioning of the core values of the policy is unclear, and the lack of 'regional cultivating' thinking on development of long-term care. To taking the Taichung City Government as an example, the current strategies adopted for how to effectively promote the investment of more long-term care services agencies, and guide the cultivating of regional development on long-term care to integrate the enhancement of the long-term care capacity are firstly, the merge of businesses and organizations for the elderly, secondly, the service areas divided on the basis of districts and townships, thirdly, the promotion of a special commissioned relationship, and fourthly, the promotion of assessment and services for the integrated payment system. In order to have objective and pragmatic experimental results by carrying out the test comprehensively, it is essentially and necessary to co-operate in specific measures of enhancing the long-term care capacity for central and local governments. To ensure that long-term care policy 2.0 will implement countrywide successfully, it is strongly recommended that the central government should work closely on research and development with the local governments. In response to the impact of Taiwan's rapid aging, it is the pressing issue to promote the sustainable development of long-term care effectively and to continue Taiwan's long-term care services through a sound and reasonable payment system.