长期照护2.0：2017年台湾居家与社区长期照护改革

LTC 2.0: The 2017 reform of home- and community-based long-term care in Taiwan.

作者信息

Hsu Hui-Chuan, Chen Chen-Fen

机构信息

School of Public Health, Research Center of Health Equity, College of Public Health, Taipei Medical University, No. 250 Wuxing St., Taipei City 11031, Taiwan, ROC.

Department of Social Welfare, Chinese Culture University, No.55, Hwa-Kang Road, Yang-Ming Shan, Taipei City 11114, Taiwan, ROC.

出版信息

Health Policy. 2019 Oct;123(10):912-916. doi: 10.1016/j.healthpol.2019.08.004. Epub 2019 Aug 20.

DOI:10.1016/j.healthpol.2019.08.004

PMID:31455563

Abstract

Taiwan planned to establish a social insurance-based long-term care system in 2016. However, due to the change in political parties that year, it was decided that Taiwan's long-term care policy would remain a tax-based financing scheme. The new policy focuses on providing home- and community-based service (HCBS); a three-layer HCBS service network within towns and districts was set to provide the 17 types of services in the HCBS spectrum, including preventive care. The reform was criticized as being too restrictive and lacking flexibility. However, the HCBS service spectrum has been widened, the target group has been enlarged, and thus HCBS utilization has increased. A rolling amendment has continued into 2018: the HCBS system requirement has been eased, and a new capitalized fee-for-service payment system has been launched. This paper discusses the analysis of the policy reform.

摘要

台湾原计划在2016年建立基于社会保险的长期护理体系。然而，由于当年政党轮替，最终决定台湾的长期护理政策仍维持以税收为基础的筹资方案。新政策着重于提供居家和社区服务（HCBS）；在乡镇和地区建立了三层HCBS服务网络，以提供HCBS范围内的17种服务，包括预防保健。此次改革被批评过于严格且缺乏灵活性。然而，HCBS的服务范围已扩大，目标群体也有所增加，因此HCBS的利用率有所提高。到2018年仍在持续滚动修正：放宽了HCBS系统要求，并推出了新的按服务收费的资本化支付系统。本文探讨了对该政策改革的分析。