從整合照顧發展檢視台灣社區整合照顧系統之建置

Reviewing the establishment of Taiwan’s integrated care system in community from the perspective of integrated care development context

本文從整合照顧的定義彙整開始，耙梳英國與日本從慢性病管理、強化自我健康管理到建構社區共生，認為良好的整合照顧體制仍是需回歸到社區本身的量能強化。在台灣，照顧服務可分為社政體系主導、衛政體系主導及跨越社政及衛政的長期照顧制度。但不管健康照護或社會照顧，都在長期照顧制度的引入後，受到深重的影響。本文認為「以人為本」、「全人照顧」的核心基礎，仍是在個人參與整合照顧溝通協商能力提升與賦能上，個人也並非僅是疾病的載體，只具有疾病治癒的需求，社會照顧的發展是重要的，同時有足夠的環境支持，促進個人對健康責任的重視與落實也才能切實，而台灣整體的高齡照顧體制也需在此目標前提下通盤檢討與再思考。

 

This article reviewed the United Kingdom and Japan’s integrated care system development. These case studies indicate that the government must strengthen its community care capacity to provide a high-quality care system. The social care service of Taiwan is managed by the social administration, and health care is managed by the health administration. However, both systems have been affected by the long-term care policy. An integrated system could prevent care resource waste and increase benefits for care recipients. The present article argues that improving people’s ability to be involved in the care integration process can achieve the “People-oriented” and “Holistic Health Care” goals. Furthermore, increased environmental support may encourage the public to notice and practice personal health responsibilities. Therefore, in Taiwan, more structural consideration should be placed on the development of an integrated system on the community side at this policy beginning stage.