我國山地離島偏遠地區社區化長照服務據點計畫之回顧與展望

Retrospect and Prospect of the Plan of Localization and Community-based Long Term Care Service System in Remote Areas

從2010 年開始至2015 年政府共補助53 個偏遠地區（含山地離島）設置在地且社區化長期照護服務據點（簡稱偏鄉長照據點），有47 個偏鄉長照據點在2015 年仍在執行；此47 個據點的老人佔全國老人4.3%；從供給面檢視，發現據點執行後，在地服務提供單位家數、在地照顧服務員之培訓及實際從業人數、在地志工人數，以及投入服務的志工人數，皆有大幅增加；從利用面檢視，發現據點已具顯著成效，有四項長照服務利用優於全國很多，包括居家服務（9.13%）、家庭托顧（49.72%）、老人營養餐飲（21.76%）、社區及居家復健（6.10%）；日間照顧服務、輔具購租及居家無障礙環境改善略優於全國；惟在交通接送、住宿型長照機構服務、居家護理及喘息四項服務的表現較全國低。偏鄉長照據點計畫的成功，代表偏鄉也有長照服務的需要，因此政府未來可將偏鄉長照據點計畫擴及至所有山地離島與偏鄉，提供更多的長照服務，縮小城市與偏鄉長照資源與服務的落差。

Fifty three remote areas (including mountainous areas and islands) had been joined in the localized and community-based long term care service program since 2010. There were 47 remote areas still in this program in 2015. The number of elderly in these 47 areas accounted for 4.3% of the total elderly population in the country. From supply side to evaluate this program, the number of long term care facility, care trainee and worker, and the volunteer worker were increased sharply. From utilization side, the program in these areas had a significant effect. The utilization of home care service (9.13%), family support service (49.72%), elderly food service (21.76%), and community and residential rehabilitations (6.10%) were much higher than national. The utilization of day care service and assistive device were slightly higher than national. The application of improvement of barrier free environment in 47 areas was slightly better than national. However, the utilization of transportation pick-up services, institutional care services, home care nursing service, and respite services were lower than national. This successful program showed that there is a need of long term care service. Therefore, government could extend the program to every remote area in order to provide more long term care service and reduce the service gaps between urban and rural areas.