| 中文摘要 |
台灣長期照顧十年計畫2.0和日本介護制度皆以發展社區照顧為目標。本文回顧日本介護政策因應國內「照護意識轉變」和「政策永續原則」啟動社區力量、整合醫療和福祉支持服務之變革。本研究與日本早稻田大學合作，透過日本長照學者剖析介護政策脈絡，反思並提出我國長照政策建議。日本介護制度從「社會福利制度」轉變為建構「地域性整合照顧服務體系」，並融入在宅、醫療、介護、介護預防、生活支援等要素，讓高齡及獨居長者能在習慣居住的區域持續生活終老，目前日本介護制度的改革方向已朝抑制照護費用並強化失能預防策略。本文就日本介護制度修正軌跡，提出三項政策建議，包括「落實長照和醫療一體化」、「強化社區預防照顧實證策略」、「健全台灣照顧服務體系全天照護與多元整合機制」，並作為台灣長照政策省思。
The Taiwanese 10-year Long-Term Care Plan (LTC) 2.0, which is in line with Japanese LTC program, aims at developing an integrated community-based care system. This study reviewed the paradigm changes in elderly care and sustainable policy development principles implemented in Japan, the evolution of community empowerment, and the integration of Japan's health care and LTC services. This study collaborated with researchers from Waseda University, who outlined the historical context for the development of the Japanese LTC system; reflected on the lessons learned from Japan's experiences; and developed recommendations for Taiwan's future LTC policy. The Japanese LTC system evolved from a government welfare system to an integrated community-based care system, with the primary aim of providing assistance to the elderly-with and without family caregivers-by incorporating home health care, medical care, LTC, disability care, and support for daily activities. Japan's current LTC programs are designing strategies to decrease the burden of LTC costs and develop evidenced-based practices for the prevention of disabilities in their high-risk population. The current study reflected on the trajectories of Japanese LTC policy revolution and developed the following proposals for future Taiwanese LTC policymaking: (1) implement a comprehensive care continuum for medical and LTC services; (2) strengthen evidence-based disability prevention programs for community elderly; and (3) develop an efficient, 24-hour integrated home- and community-based LTC service system. |
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