C級巷弄長照站整合照顧的現況、挑戰與機會──世界衛生組織整合照顧（ICOPE）服務層次之觀點

The current situation, Challenges and Opportunities to implement Integrated care in '' The Alley Long-Term Care Service C Station''- The View of World Health Organization's ICOPE MESO level approach

臺灣人口老化速度飛快，從高齡轉變為超高齡社會僅需7年，因人口結構改變，高齡者亦逐漸成為社會中主要的依賴人口，高齡社會所帶來的照顧問題是不可忽視的重要議題。臺灣遂於2016年實施長照2.0，強調在地老化和社區照顧的精神，推行ABC社區整體照顧服務體系，希望能讓高齡者回歸家庭與社區，其中C級巷弄長照站（C點）即是在地化長照服務輸送網絡的最前端，提供高齡者社區整合照顧服務。C點即將邁入第五年，有必要進行一個品質的檢核以作為未來指引。本文即以WHO倡議的ICOPE中觀層次評估方法檢核目前C點在提供整合照顧上的現況、挑戰與機會：發現目前C點與WHO所期盼的整合照顧仍有一段距離，原因主要為：（1）缺乏跨專業合作的機會，與AB的照顧資源網絡脫節、（2）缺乏具有專業知能的人力、（3）照顧功能的定位不明確。本文建議宜重新思考C點在ABC體系中的定位、整合跨專業的人力資源和照顧網絡、及強化C點整合照顧的功能，以提供高齡者以人為本的整合照顧模式。

Taiwan is the fastest aging countries in the world, it is estimated that only takes 7 years to transform from an aging society to a super-aged society. Due to the changes in the demographic structure, the older people would become the main dependent population in the society. The care problems bring by the aging society are important issues that cannot be ignored. In 2016, Taiwan implemented long-term care（LTC）2.0, emphasizing the spirit of aging in place and community care, and implemented the ABC Integrated community care service system, it hoped that the older people could return to their families and communities. Among them, The Alley Long-Term Care Service C Station（C Station）was the forefront of the LTC service delivery network, provide community integrated care services for the older people. This article used the WHO ICOPE meso-level assessment method to evaluate the current status, challenges and opportunities of the integrated care in C Station. It found that there was a gap between the C Station and the WHO expect that. The main reasons were:（1）lacked of opportunities for interdisciplinary cooperation, disconnection with LTC resource network in AB system（2）insufficient human Resources and professional knowledge,（3）unclear position of care function. The suggestions of this research were as follows:（1）Reposition the role of C Station in the ABC system,（2）Integrate the interdisciplinary team and LTC resource networks,（3）Strengthen the integrated care function of C Station, to provide a person-centered integrated care for the older people. Taiwan is the fastest aging countries in the world, it is estimated that only takes 7 years to transform from an aging society to a super-aged society. Due to the changes in the demographic structure, the older people would become the main dependent population in the society. The care problems bring by the aging society are important issues that cannot be ignored. In 2016, Taiwan implemented long-term care（LTC）2.0, emphasizing the spirit of aging in place and community care, and implemented the ABC Integrated community care service system, it hoped that the older people could return to their families and communities. Among them, The Alley Long-Term Care Service C Station􇂷C Station􇂸was the forefront of the LTC service delivery network, provide community integrated care services for the older people. This article used the WHO ICOPE meso-level assessment method to evaluate the current status, challenges and opportunities of the integrated care in C Station. It found that there was a gap between the C Station and the WHO expect that. The main reasons were:（1）lacked of opportunities for interdisciplinary cooperation, disconnection with LTC resource network in AB system（2）insufficient human Resources and professional knowledge,（3）unclear position of care function. The suggestions of this research were as follows:（1）Reposition the role of C Station in the ABC system,（2）Integrate the interdisciplinary team and LTC resource networks,（3）Strengthen the integrated care function of C Station, to provide a person-centered integrated care for the older people.