我國長照政策之發展趨勢及對護理專業的影響

The Development of Long-Term Care Policies and the Impact on Nursing

台灣面對高齡、少子女、少勞動力的人口趨勢，政府除發展社區活躍老化政策，須同時強化醫療照護與長期照護（長照）體系的運作。全民健保要永續經營，需改革支付制度，急性後期照護會朝以居家及社區為主、住院式為輔發展；長期照護服務法的通過將整合分散在各法的長照服務單位、設置長照發展基金、結合長照服務網、獎補助長照資源不足社區發展長照資源、改善長照服務品質與分布；長期照護保險法的規劃，支付制度將採包裹式支付以協助失能家庭；長照服務之提供需強化資源整合與效率提升；長照業務資訊化與雲端整合，將使長照體系運作更透明有效率。護理人員較其他社區專業人員更擅長老年照護與諮詢，但仍較缺乏經營與管理培訓；未來居家與社區式照護需更多優秀人力投入，將增加護理人員創業或彈性工作契機；護理人員需強化急性後期照護、獨立創業、經營管理及專業合作協調等能力，以掌握護理專業在長照領域發展之契機。

The government must reform and enhance current medical and long-term care services in order to respond effectively to societal ageing and labor shortage trends and to ensure sustainable operations. The post-acute care system should be reoriented on the home and community instead of the hospital. The Long Term Care Service Act integrates long-term care services that were previously dispersed amongst different departments, sets up a long-term care development fund, and improves the quality and allocation of long-term care services. Moreover, the Long Term Care Insurance Act will implement a bundle payment system to assist disabled families. The integration of automation and information technology will make long-term care more efficient. Although nurses are more skilled at elderly care and counseling than other community care professionals, nurses generally lack training in business management. Home and community-based services thus require better-trained manpower, opportunities to set care agents, and opportunities to offer flexible caring jobs. Therefore, nurses should strengthen their capabilities in post-acute care, business management, cooperation, and coordination.