長期照顧項目下社區整體照顧服務體系之實證研究

Empirical Research on Community Care Service System under Long-term Care Project

"依據國發會（2018）人口人力推估，臺灣已於1993年邁入高齡社會，高齡化速度超過歐美日等先進國家，預計將於2026年成為超高齡社會，人口老化速度為全球第一，是臺灣現在正面臨的重大課題。有鑑於此，人口結構快速走向高齡化，相對的長期照顧需求人數也因此增加。本研究運用Saaty提出的利益、機會、成本、風險（Benefits, Opportunities, Costs, Risks, BOCR）為主要研究架構，蒐集相關文獻發展其評估之次準則，並應用層級分析法（Analytic Hierarchy Process, AHP）及進行敏感度分析，將長照ABC經營選擇系統化。本研究結果發現長照ABC重要構面排序為成本、機會、利益、風險，而準則之重要性排序為「人事成本」、「自主性」、「長照人員供需問題」及「土地法規」，且以「巷弄長照站－C方案」為最優先，其次為「社區整合型服務中心－A方案」及「複合型服務中心－B方案」，另外運用敏感度分析時，可以進一步得知，針對以「巷弄長照站－C方案」為導向時，重點應放在「成本」上的控管。而是針對社區整合型服務中心－A為導向時，重點應放在「普遍接受度」方向上。此研究結果可供政府政策相關決策之參考。"

Based on the population estimate from National Development Council (NDC) (2018), Taiwan is in aging society since 1993, and the aging speed is faster than many developed countries such as Europe, the United States of America, and Japan. Taiwan is now facing a major issue on population aging because it is expected to become a super-aged society by 2026, which will become the highest population aging rate in the world. In the light of this, Taiwan’s population structure is rapidly aging, and the needs for long-term care number has also increased. This study systemized the selection for long-term care ABC level management by using Benefits, Opportunities, Costs, Risks (B.O.C.R.), proposed by Saaty, as the main research framework, collecting relevant literature for sub-criteria, and applying Analytic Hierarchy Process (AHP) and Sensitivity Analysis. Results showed that Costs is the most important dimension in long-term care ABC level, followed by Opportunities, Benefits, and Risks respectively. The importance of criteria is followed by personnel costs, autonomy, supply and demand of long-term care, and land regulations respectively. The importance of options for care selection is followed by Level C Alley Long-term Care Station, L0065vel A Integrated Community Services Center, and Level B Compound Community Services Center respectively. Additionally, using sensitivity analysis confirmed that Level C Alley Long-term Care Station should focus on costs control; whereas, Level A Integrated Community Services Center should focus on general acceptance. This research can provide as a reference for long-term care related government decisions.