公私合夥下評鑑制度運作的風險：老人福利機構觀點之探析

Risk in Evaluation System Operations for Public-private Partnerships: An Examination of Eldercare Institutions

臺灣近年因政府財政窘困與人口快速老化，政府與老人福利機構合夥提供養老服務，已成為高齡照顧的重要選項。因此，老人福利機構在服務供給設置的控管與後續管理，已成為政府治理中不可忽視的問題。然綜觀公共行政領域過去研究，大多站在政府中心思維，檢視受託組織該如何承擔責任與扮演好服務輸送的角色，卻鮮少從受託組織的立場來評估公私合夥關係和管理機制的良窳。據此，本研究從老人福利機構管理者的角度出發，以臺南市在2015年立案合格的113間老人福利機構為研究範圍，透過郵寄問卷調查公私合夥關係的品質，及瞭解其對機構評鑑制度的看法，共計回收48份問卷，回收率為42.28％。本研究主要發現如下：（1）小型機構相較於中大型機構來說，會覺得較不受到主管機關的尊重；（2）小型機構相較於大型機構，覺得評鑑指標有更多窒礙難行或與現實不符之處；（3）評鑑目前仍落於形式主義，評鑑效能與考核成本之間存在落差。本研究彙整機構管理者的意見，並提出具體的政策建議，供未來機構評鑑指標修正的參考。

In recent years, due to fiscal constraints and an ageing society, public-private partnership (PPP) has been seen as one of the best strategies for providing eldercare in Taiwan. Hence, management of collaborative mechanisms for eldercare service provision has become an important topic in public administration and social policy. However, most scholars examine the issue from a government-centric viewpoint, focusing on how to reduce the costs of collaborative mechanisms through monitoring of the private institutions entrusted by the government to provide eldercare. These analyses completely neglect the possibility that the government is in fact the primary cause of problems in these collaborative efforts. This paper examines how transaction costs imposed by the government might lead to failures in eldercare provision by investigating eldercare institutions in Tainan City. Mail-questionnaire survey data collected from the managers of 48 eldercare institutions in Tainan are analyzed. The study's findings indicate that (1) compared with middle-sized and large institutions, small institutions feel the government does not respect them enough; (2) smaller institutions are more likely than middle-sized and large institutions to view evaluation indicators as difficult or unrealistic and as inconsistent with their current needs; (3) operation of the evaluation system suffers from formalism and a gap exists between the effects and costs of evaluation. The study offers policy suggestions for modifying eldercare institution evaluation in the future.