建構長期照護體系先導計畫—理念與實踐

Abstract

目標：本文說明建構長期照護體系先導計畫的理念、計畫策略、和初步執行結果。該計畫希望能以可負擔的居家和社區式服務協助身心功能障礙者，以達到「在地老化」的目標。方法：在 2000 年行政院核定「建構長期照護體系先導計畫」三年計畫。該計畫選擇嘉義市和台北縣三鶯為實驗社區，於2001年10月分別在兩社區成立社區中心，每一中心配置4-5位照顧經理，一位主任，和一位行政專員，負責推展照顧管理服務、及督導新型服務模式的發展。從2002年1月起，社區開始提供各項居家和社區式服務。結果：到2002年7月為止，照顧經理總共替 1031位個案擬定照顧計畫，其中，469位個案依據照顧計畫接受服務。除補助兩社區新型服務的開辦費（約1400萬元）外，兩社區補助民眾接受服務的費用共約474萬元。結論，初步結果顯示服務提供者有發展居家和社區式服務的意願，但是民眾對此服務並不熟悉，可能造成初始之低使用率。在計畫的補助標準和照顧管理制度的設計下，提供居家和社區式服務的財務負擔並不如預期沈重，但須更長的觀察，才能驗證上述之成果。

Objectives: This report described the conceptual framework, strategic planning and implementation, and preliminary results of the Pilot Program for the Development of Long-Term Care System. The program aimed to achieve “Aging in Place” by making home and community-based services affordable to the disabled. Methods: In the year 2000, the Executive Yuan approved a three-year project, the Pilot Program for the Development of Long-Term Care. Chia-Yi City, and the San-Yin Townships of Taipei County were selected as experimental communities. In October, 2001, a community center was established in each experimental community. Personnel included 4-5 care managers, 1 director, and 1 administrative assistant. The main tasks of the center were to carry out care management scheme, and to supervise new long-term care service models being implemented in the communities. Starting in February 2002, home and community based services became available to the disabled in the communities. Results: By the end of July 2002, care managers had drawn up care plans for l,031 disabled residents. Among them, 469 people had used home or community-based services according to a care plan. Subsidies to service providers were at about 14 million NT dollars. Reimbursement for services totaled about 4.74 million NT dollars . Conclusions: Initial results had shown that service providers were willing to invest in developing resources for home and community based services. Unfamiliarity with the services had probably initially led to lower than expected level of utilization. Under the current care management and service reimbursement schemes, financial burden of providing home and community based services was not as heavy as anticipated. However, continual observation 15 needed to confirm initial findings.