我國機構式喘息服務政策之分析與建言

The Analysis and Recommendation of the Institutional Respite Care Policy in Taiwan

台灣社區老人因功能障礙而需要長期照護的人數與日俱增，主要照顧者身、心、社會的負荷漸受重視，為減低照顧者的負荷，我國於西元1998年開始施行機構式喘息服務政策，實施至今使用喘息服務的人數已漸增，但並不如預期的理想。本文主要透過文獻查證及訪談等方式，就喘息服務政策形成的環境背景、政策相關現況及問題進行政策剖析，結構、過程、成果為主要分析架構：結構包括需求及資源；過程含衛生政策規劃流程、衛生行政流程及服務輸送過程；成果包括服務利用率、服務滿意度、照顧者的健康安適及機構化情形，並依據分析結果從政策、實務及教育研究等面向提出建言，期能作為未來喘息服務政策修正及推動之參考，讓辛苦的照顧者得以獲得休息，在地老化的理想得以實現。

As the functionally impaired disabled elderly and the long-term care population has grown, concern about the physical, psychological and social demands facing primary caregivers has increased. An institutional respite care policy was adopted in Taiwan in 1998, but the rate of utilization of institutional care remains low. This article investigates the formative background, related circumstances and problems of respite care policy. The three dimensions of structure, process and outcome form the main framework for policy analysis. ”Structure,” includes demand and resources. ”Process,” includes health policy planning procedure, health administration and service delivery processes. ”Outcome,” covers service utilization, satisfaction, caregiver's well-being and care-receiver's institutionalization rate. In accordance with the results of the analysis the researchers propose recommendations about policy, practice, education and research, in the hope that these will be considered in relation to future modification and execution of respite care policy, in order to provide respite for suffering caregivers, and to carry out the ideal of aging in place.