運用平衡計分卡與層級分析法建構失智社區服務據點評核指標之研究

Developing Evaluation Indicators for Dementia Community Service Centers Using the Balanced Scorecard and Analytic Hierarchy Process

台灣邁入高齡社會，依據衛生福利部2020至2023年全國社區失智症流行病學調查結果，65歲以上失智症盛行率為7.99%，且隨年齡增長而上升。衛生福利部自2017年起推動長照十年計畫2.0，將50歲以上失智症者納入服務對象，設立失智社區服務據點，實現在地老化與社區照護。失智據點的設置與服務規模擴展，及與社區、長照機構之間的聯繫與合作，已成為失智社區照護的主要挑戰。然而，據點經營者與服務人員專業背景差異，是否對政策執行的認知與實踐方式有所不同，現行評核指標的適用性及權重分配是否能充分反映據點個別性及運作成效，有待進一步探討。本研究採用平衡計分卡建構評核指標，結合修正層級分析法計算權重，系統性分析各層面指標的重要及關連性。結果顯示，顧客構面為提升服務品質的關鍵因素，其權重在產業主管、政府機關管理人員及專家學者分別為0.35、0.38、0.41；財務構面權重較低，分別為0.12及0.19，反映出對經費補助政策及財務自主能力的信心不足。此外，透過集群分析法，發現「非依賴經費補助、自訂財務策略規劃」為重要財務策略，顯示各界期望失智據點逐步實現財務自主。本研究評核指標的建立將有助於引導失智據點未來發展方向，並提供政策制定參考，提升失智照護服務質量及永續發展。

Taiwan has entered an aging society, with the national epidemiological survey on dementia in community-dwelling older adults conducted by the Ministry of Health and Welfare (2020–2023) indicating a prevalence rate of 7.99% among individuals aged 65 and above, which increases with age. In response, the Ministry of Health and Welfare launched the Long-Term Care 2.0 Plan in 2017, extending services to individuals aged 50 and above with dementia and establishing community-based dementia service centers to promote aging in place and community care. However, the expansion of dementia service centers, the scale of services, and coordination with long-term care institutions and community networks have posed significant challenges. Additionally, differences in the professional backgrounds of center operators and service personnel may influence their perceptions and implementation of policies. The applicability of existing evaluation indicators and their weight distribution in accurately reflecting the uniqueness and operational effectiveness of each center requires further investigation.
This study employs the Balanced Scorecard (BSC) framework to construct evaluation indicators and integrates the Modified Analytic Hierarchy Process (AHP) to determine indicator weights, systematically analyzing their significance and interrelationships. The results indicate that the customer dimension is the key factor in enhancing service quality, with respective weights of 0.35, 0.38, and 0.41 assigned by industry supervisors, government administrators, and scholars. In contrast, the financial dimension received lower weights of 0.12 and 0.19, reflecting concerns regarding financial subsidy policies and the centers’financial autonomy. Furthermore, cluster analysis identified“non-reliance on subsidies and self-formulated financial strategies”as a crucial financial strategy, suggesting a collective expectation for dementia service centers to gradually achieve financial independence.
The establishment of these evaluation indicators provides a systematic framework for guiding the future development of dementia service centers. The findings offer valuable insights for policymakers, contributing to the enhancement of dementia care service quality and long-term sustainability.