我國長照制度之創新研究- 借鏡日本第三方評估系統

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题名:	我國長照制度之創新研究- 借鏡日本第三方評估系統 Innovative Research on Long-Term Care System in Our Country - Drawing Insights from Japan's Third-Party Evaluation System
作者:	陳潔玉
贡献者:	社會企業管理碩士在職學位學程
关键词:	長照機構評鑑制度社會創新日本第三方評估 long-term care institutions evaluation system social innovation Japan's third-party evaluation
日期:	2024
上传时间:	2024-07-17 12:43:40 (UTC+8)
摘要:	隨著台灣進入高齡社會，長期照顧需求迫切增加，成為政府當前的重要議題。為因應高齡人口增加的趨勢，政府自2017年起推動長照2.0計畫，預算大幅增加，持續強調在地老化，提供居家式、社區式和住宿式的照護服務，並積極推動新的支付制度。在台灣，長照機構的照顧情境複雜，關係結構呈現多層次網絡，涉及多元的委託與代理。為了維護良好的長照品質，政府通過「長期照顧服務法」和「長期照顧服務機構評鑑辦法」對機構進行監督和評估。然而，現行評鑑制度存在著公開程度不足、僵化、信效度不高等問題，無法充分作為消費者選擇長照機構的參考依據。我國長照政策上面，常參考鄰近國家日本的政策，因此想藉由日本「第三方評估」來精進及改良評鑑機制，足以達到可供民眾選擇的參考，及有效的汰換品質不良的機構。透過社會創新，可以提出改善現行評鑑制度的建議，使其更具彈性和有效性。這樣的改革不僅能夠提供更可靠的評鑑機制，還能夠為消費者提供更具體、可信的資訊，讓他們能更有信心地做出長期照顧機構的選擇。透過日本的第三方評估經驗，我們可以為台灣長期照顧機構帶來系統性革新。改進的評鑑制度不僅可以促進內部品管系統的調整和改進，還可以提高政府對長期照顧機構的監管效能及消費者的選擇信心，確保受服務者的安全和提供的服務內容。本研究旨在引導社會資源更有效地應對人口老化所帶來的挑戰，並提供給民眾更可靠的長照服務選擇參考。透過日本第三方評估研究期待帶給臺灣長照機構社會創新的如下啟示： 1.從長照機構內，服務使用者的角度進行評估，按照其規模及性質規劃指標，以突顯鑑別度； 2.評估結果能提供更具體且客觀的資訊； 3.提高評鑑標準一致性； 4.化被動為主動，延聘第三方評估機構進行評估，落實評鑑意涵； 5.以評鑑結果作為未來組織改革的方向與目標。 As Taiwan enters an aging society, the demand for long-term care has urgently increased, becoming a significant issue for the government. To address the growing trend of an aging population, the government launched the Long-Term Care 2.0 plan in 2017, significantly increasing the budget and continuously emphasizing aging in place. This plan provides home-based, community-based, and residential care services while actively promoting new payment systems. In Taiwan, the care situation within long-term care institutions is complex, with relationship structures presenting multi-layered networks involving diverse entrustment and agency. To maintain good quality in long-term care, the government supervises and evaluates institutions through the "Long-Term Care Services Act" and the "Evaluation Regulations for Long-Term Care Service Institutions." However, the current evaluation system has issues such as insufficient transparency, rigidity, and low reliability and validity, making it inadequate as a reference for consumers choosing long-term care institutions. 　　Our country's long-term care policies often refer to those of neighboring Japan. Therefore, we aim to improve and refine our evaluation mechanism by adopting Japan's "third-party evaluation" approach. This will provide a reference for the public to make informed choices and effectively eliminate low-quality institutions. Through social innovation, we can propose suggestions to improve the current evaluation system, making it more flexible and effective. Such reforms will not only provide a more reliable evaluation mechanism but also offer consumers more specific and credible information, enabling them to confidently choose long-term care institutions. 　　By leveraging Japan's third-party evaluation experience, we can bring systematic innovation to Taiwan's long-term care institutions. An improved evaluation system can not only facilitate adjustments and improvements to internal quality control systems but also enhance the government's regulatory effectiveness over long-term care institutions and boost consumer confidence in their choices. This ensures the safety of service recipients and the quality of the services provided. 　　This research aims to guide social resources in more effectively addressing the challenges posed by an aging population and to provide the public with more reliable references for choosing long-term care services. By studying Japan's third-party evaluation system, we hope to bring the following insights for social innovation in Taiwan's long-term care institutions: 1. Conduct evaluations from the perspective of service users within long-term care institutions, designing indicators based on their scale and nature to highlight differentiation. 2. Provide more specific and objective information through evaluation results. 3. Improve the consistency of evaluation standards. 4. Shift from a passive to an active approach by hiring third-party evaluation agencies to conduct evaluations, thus realizing the true meaning of evaluations. 5. Use evaluation results as a direction and goal for future organizational reforms.
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