社區整合型服務中心評鑑結果與相關因素之探討

Results and Related Factors of Integrated Community Service Center Accreditation

背景：社區整合型服務中心旨在確保社區內的各項長照資源能符合服務區內失能者的需求，且擁有足量、勝任職務的個管員，以將失能者所需的長照服務做有效率，與有效果的輸送。 目的：本研究旨在瞭解臺灣社區整合型服務中心( 簡稱A單位)，開辦後的經營情形，與影響其經營品質的因素。 方法：採次級資料分析，對中部某縣市83 所A單位，接受第一次評鑑的結果做探討。 結果：近九成的受評單位(n = 73, 88.0%) 為合格，優良6 所(7.2%)，待觀察4所(4.8%)。去除加分題架構，其他四大架構完全符合者，依序為行政管理64.4%，服務安排53.5%，使用者端意見與管理43.1%，與服務品質37.6%。個管人員數、月個案量、與服務得分間呈顯著相關(p < .01)；A 單位的類別與所在區域，不會影響其評鑑總分。25 位評鑑委員對五大架構的建議總次數，依序為服務安排、行政管理、服務品質、使用者端意見與管理、及加分題。 結論：長照中心的照顧管理，與A 單位的個案管理，二者相輔相成，能發揮社區整體照顧模式的成效。依評鑑結果提出討論與建議，以供長照相關單位參酌。

Background: The integrated community service center aims to ensure that various longterm care resources in the community meet the needs of people with disability in the service area, and that sufficient and competent case managers are available for the provision of long-term care services required by the people with disability for efficient and effective service delivery. Purpose: The present study explored the operations of Taiwan’s integrated community service center (unit A for brevity) after its establishment and the factors associated with its operation quality. Methods: The first accreditation results of 83 unit As in a county of central Taiwan were investigated through secondary data analysis. Results: The results showed that nearly 90% (n = 73, 88.0%) of the unit As were qualified, 6 were excellent (7.2%), and 4 still needed to be evaluated (4.8%). Among the five dimensions, except for the bonus question dimension, the remaining four dimensions were completely compatible, namely administrative management (64.4%), service arrangements (53.5%), userside opinions and management (43.1%), and service quality (37.6%). A significant correlation was observed among the number of case managers, amount of service, and service dimension score (p < 0.01); the type and area of unit A did not affect its total evaluation score. According to the suggestions made by 25 evaluation committees, the five dimensions were scored in the following order: service arrangements, administrative management, service quality, user-side opinions and management, and bonus question. Conclusions: The collaboration of care management in the long-term care center and case management in unit A can promote the effectiveness of the community-based integrated care model. The evaluation results and suggestions can serve as a reference for relevant long-term care institutions.