臺北市社區與居家式長期照顧機構評鑑指標之建置

To Establish the Accreditation Indices for the Community and Home-based Long-Term Care Facilities of Taipei City

背景：依據「長期照顧服務法」第39條，主管機關對長照機構應予輔導、監督、考核、檢查及評鑑，以落實主管機關對長照機構的管理責任。目的：建置合宜的社區與居家式長期照顧機構評鑑指標。方法：匯集臺北市政府社會局長照機構相關績效考核、評鑑及相關文獻採用的指標；聘請長期照顧相關領域專家學者召開專家會議建構評鑑基準；再邀請臺北市服務單位參加公眾討論會，並酌參其建議後完成。結果：評鑑指標的核心是確保使用服務者的安全與權益保障，評鑑指標分為個案權益保障、專業照護品質、經營管理效能、及安全環境設備四大構面。對於不同形式之長照機構，其採用之評鑑指標項目及項數略有不同，社區式服務單位機構的評鑑指標題項分別為日間照顧42題、小規模多機能44題、團體家屋57題、家庭托顧19題；居家式服務單位，居家服務28題，併居家護理為38題、併復健32題、居家服務併護理及復健為39題。結論：指標可引導長照機構建立例行性管理機制，確保長照機構提供服務對象良好安全的照顧與環境；因應人口邁向超高齡社會，政府應定期檢討各類長照機構的評鑑指標，朝以個案為中心的整合性專業照護與品質維護努力。

Background: According to Article 39 of the Long-Term Care Services Act, governmental authority should provide guidance, supervision, evaluation, checking and accreditation of long term care facilities. Purpose: To setup appropriate accreditation indices for the home and community based long-term care facilities. Method: The related evaluation indices, performance appraisal, information and documents from the Taipei City Social Bureau were assembled in this study. Then experienced scholars and experts from the professional field were invited together to construct the basis of the accreditation indices for the public hearing. At last the indices were strengthen by the opinions of the people and outstanding services parties. Result: The core concept of accreditation indices is to assure the safety and right of clients. The accreditation indices were divided into four frames: protection of client’s rights and interests, quality of professional care, efficacy of management, and safety of environment. The content and item numbers of accreditation indices are different according to the type of long-term care facilities. There are 42 items of accreditation indices of day care center, 44 items of small-scale and multifunctional Service, 57 items of group home, 19 items of home base day care, 28 items of home-services, 38 items of home nursing, 32 items of home rehabilitation, and 39 items of home-services combined with home nursing and rehabilitation. Conclusions: The accreditation indices are helping long term care facilities to maintain good and safe environment for disable aged people. Facing rapid ageing society, government should reevaluate the accreditation indices of each type of long-term care facilities for the integrated client-centered professional care and quality assurance.