Chou Yueh-Ching, Kröger Teppo, Pu Cheng-Yun
Institute of Health and Welfare Policy, Research Center for Health and Welfare Policy, National Yang-Ming University, 155, Li-Nong St, Sec.2, Peitou, Taipei, 112 Taiwan.
Department of Social Sciences and Philosophy, University of Jyväskylä, Jyväskylä, Finland.
Eur J Ageing. 2014 Sep 27;12(2):95-104. doi: 10.1007/s10433-014-0322-z. eCollection 2015 Jun.
The four main models of long-term care (LTC) for older people in Taiwan are institutional care, community and home-based care, live-in migrant care and family care. This study aims to examine the factors associated with the four above-mentioned LTC models, using the Andersen model as its framework for analysis. Data were from the 2005 National Taiwanese Health Interview Survey ( = 30,680), and in this study, 592 over 65-year-old persons who require personal care in daily life were included. The findings showed that the majority of older people with care needs lived with family and were cared only by their family. The second largest group was those older people who were cared by migrant care workers, and the third group used institutional care. Only a very small proportion used community/home-based care services. If older people had intensive care needs, they either hired migrant care workers or used institutional care, depending on social and economic backgrounds. Multinomial logistic regression results showed that the way how disabled older people use different LTC models was affected by three components of the Andersen model: their needs (level of ADL and IADL), predisposing factors (age, education) and enabling factors (family networks). Results suggest that there is a need for LTC policies in Taiwan to provide more available and accessible community/home-based care services, particularly for older people with intensive care needs, in order to support their 'ageing in place' and to decrease the use of migrant care workers.
台湾老年人长期照护（LTC）的四种主要模式是机构照护、社区及居家照护、住家外籍劳工照护和家庭照护。本研究旨在以安德森模型为分析框架，探讨与上述四种长期照护模式相关的因素。数据来自2005年台湾国民健康访谈调查（n = 30,680），本研究纳入了592名65岁以上日常生活需要个人照护的老年人。研究结果表明，大多数有照护需求的老年人与家人同住，仅由家人提供照护。第二大群体是那些由外籍劳工照护的老年人，第三大群体使用机构照护。只有极小一部分人使用社区/居家照护服务。如果老年人有密集照护需求，他们会根据社会和经济背景，要么雇佣外籍劳工照护，要么使用机构照护。多项逻辑回归结果表明，失能老年人使用不同长期照护模式的方式受到安德森模型三个组成部分的影响：他们的需求（日常生活活动能力和工具性日常生活活动能力水平）、易患因素（年龄、教育程度）和促成因素（家庭网络）。结果表明，台湾的长期照护政策需要提供更多可得且可及的社区/居家照护服务，特别是针对有密集照护需求的老年人，以支持他们“就地养老”并减少外籍劳工照护的使用。
