偏遠地區老人照顧跨部門治理研究－－ 以臺東縣池上鄉為例

A Study of Cross-sector Governance in Remote Areas: Using Elderly Care of Chihshang Township in Taitung County as an Example

隨著外在環境發展與變遷，高齡化是近年來多數國家面臨的 問題，此問題涵蓋產業經濟、社會文化、醫療照顧及勞動人口等 層面，且在偏鄉地區更為嚴重。長久以往，相關社會福利議題多 以政府為主導，然現今全球環境複雜、經濟情況變遷及公民意識 提升影響下，治理問題已非政府獨力能解決，需依靠跨部門治 理，整合政府、企業與非營利組織資源，共同承擔責任，避免在 有限資源下，公共資源的重覆投入形成浪費。至2015年止，臺東 縣池上鄉老年人口比例已高達19.51%，為因應在地老人需求，其 結合政府、企業及非營利組織，獲得豐富的活動及成果。本研究 以池上鄉為案例，採取Emerson, Nabatchi & Balogh提出的「協 力治理整合架構」及十項命題為研究架構；以老人照顧提供者為 研究對象，透過深度訪談，探討其如何透過跨部門治理，不僅滿 足在地老人照顧需求，更進一步提升老人價值與福祉。透過此研 究發現，池上鄉長期以來建立的非正式人際網絡為跨部門治理奠 定良好基礎，且老人照顧以非營利組織扮演重要的領導角色，政 府、企業與地方組織積極參與，形成良好的跨部門治理模式，透 過持續的治理成果讓老人照顧的服務範圍大幅擴展，並引進更多 外界資源。

The developments of and changes in external environments have recently rendered population aging a problem in many countries. The problem of population aging comprises several dimensions, namely industrial economics, social culture, medical care, and labor force, and the problem is more severe in remote areas. Matters relevant to social welfare have been primarily managed by the Taiwanese government. However, under the current effects engendered by the complexity of the global environment, changes in economic conditions, and the rise in civic awareness, the governance of relevant matters can no longer be solely assumed by the government, thus necessitating cross-sector governance. In such governance, shared responsibility can be implemented through the integration of government, corporate, and nonprofit organization resources. The proportion of the elderly population in Chihshang Township, Taitung County, had reached as much as 19.51% by 2015. To respond to the needs of the local older adults, the government, enterprises, and nonprofit organizations cooperate to convene numerous activities and obtain outcomes. Moreover, the integrative framework for collaborative governance proposed by Emerson, Nabatchi, and Balogh (2012) was adopted, and 10 propositions were developed for the research framework. Providers of elderly care were recruited as the research participants. Through in-depth interviews, this study investigated how cross-sector governance can satisfy the needs of local elderly care and elevate the value and welfare of older adults. This study determined that the informal interpersonal network that has been developed in Chihshang Township for the long term serves as a favorable basis for cross-sector governance; moreover, nonprofit organizations play critical leading roles in elderly care, and the active participation of the government, enterprises, and local organizations form a favorable cross-sector governance model. The outcomes of continuous cross-sector governance can substantially expand the service area for elderly care and introduce more external resources.