Department of Resources Engineering, National Cheng Kung University, Tainan 701, Taiwan.
Institute of Gerontology, National Cheng Kung University, Tainan 701, Taiwan.
Int J Environ Res Public Health. 2020 Apr 13;17(8):2649. doi: 10.3390/ijerph17082649.
In response to the irreversible aging trend, the Taiwan government has promoted the Long-Term Care (LTC) policy 1.0 launched in 2007 and the LTC policy 2.0 reform since 2016. This study aimed to explore the utilization of formal home and community-based care under LTC policy 1.0 to add scientific support for the on-going LTC policy 2.0 reform.
By using Andersen and Aday's behavioral model of healthcare utilization, the long-term care dataset was analyzed from 2013 to 2016. A total of 101,457 care recipients were identified after data cleaning.
The results revealed that about 40.7% of the care recipients stayed in the care system for more than two years. A common factor influencing the length of home and community-based services (HCBS) utilization period included need factors, where more dependent recipients leave the LTC system regardless of their socio-economic status. However, the utilization period of non-low-income households is significantly affected by the level of service resources.
For long-term care needs, the phenomenon of a short utilization period was concerning. This study adds information which suggests policy should reconsider care capacity and quality, especially for moderate to severely dependent recipients. This will allow for better understanding to help maintain care recipients in their own communities to achieve the goal of having an aging in place policy.
目的:为了应对不可逆转的老龄化趋势,台湾政府自 2007 年推行长期照护(LTC)政策 1.0,并于 2016 年开始 LTC 政策 2.0 改革。本研究旨在探讨在 LTC 政策 1.0 下正式的居家和社区护理的利用情况,为正在进行的 LTC 政策 2.0 改革提供科学依据。
方法:采用 Andersen 和 Aday 的医疗保健利用行为模型,对 2013 年至 2016 年的长期照护数据集进行分析。经过数据清理,共确定了 101457 名护理接受者。
结果:结果显示,约 40.7%的护理接受者在护理系统中停留超过两年。影响居家和社区护理(HCBS)利用期的常见因素包括需求因素,即依赖性较强的接受者无论其社会经济地位如何,都更有可能离开 LTC 系统。然而,非低收入家庭的利用期受到服务资源水平的显著影响。
结论:对于长期护理需求,利用期较短的现象令人担忧。本研究增加了有关政策应重新考虑护理能力和质量的信息,特别是对中度至重度依赖的接受者。这将有助于更好地理解,以帮助将护理接受者维持在自己的社区中,实现就地老龄化政策的目标。