日本介護保險住宅改修之實施經驗與借鏡

The Implementation of Home Modifications with Long-term Care Insurance in Japan: A Reference for Taiwan

我國長期照顧的居家無障礙環境改善政策已實施超過十年。在整合照顧、住宅及醫療服務體系之長期照顧十年計畫2.0推動中，善用居家無障礙住宅環境改善於社區式照顧服務發展是相當重要的。本文探討已實施近20年之日本介護保險之「住宅改修給付與支付」政策，發現日本於進入超高齡社會之前，已實施相當多元的無障礙住宅相關政策，且在介護保險「住宅改修給付與支付」方面，「事前申請」、「受領委任」及「業者登錄」制度，是值得我國借鏡與參考之處。本文參考日本制度實施經驗，針對我國無障礙住宅政策、居家無障礙環境改善給付制度、業者登錄制度及評估人員資格等面向，提出相關討論與建議，期作為未來相關單位規劃之參考。

Home modification policy for long-term care in Taiwan has been in place for ten years. It is important to support home modification in long-term care 2.0 plan, which is dedicated to promote integration of care, residential and medical service system, and to improve the development of community-based care services. As a reference for our future development of long-term care services, this paper explores the policy of home modification under the Japan long-term care insurance which has been in place near 20 years. The study found that Japan had implemented a number of policies related to barrier-free housing before approaching the super-aged society. And in the case of home modification of Japan long-term care insurance, ''pre-application'', ''direct debit authorization'' and ''vendors registration'' are worthy of reference. Based on the experience of the Japanese long-term care insurance, this paper gives discussion and recommendations for the barrier-free housing-related polices, plus the payment system, the vendor registration system, and the needs assessment by the qualified assistive technology professionals in Taiwan’s home modification policy of the long-term care 2.0 plan.