臺灣與英國社區長期照顧之發展歷程：福利多元主義觀點的分析

Abstract

當前臺灣長期照顧是從社區照顧關懷據點模式發展為長照1.0及2.0，與英國西元2000年之前的社區照顧發展過程相仿。本研究旨在探討英國和臺灣社區長期照顧的福利多元主義模式發展歷程。其研究方法係採用解釋性比較研究，在較複雜的體系內，探討部份政策改變的效果。研究發現，英國在機構照顧、社區內照顧之後，由1980s由社區來照顧至1993以後在社區範圍內的照顧階段，與臺灣2005之後兩階段相似。顯示臺灣從英國之模式中有所借鑒，使相關的預算支出獲得相當的控制。本研究建議高齡化國家初期以社區照顧據點自助、社區式長期照顧公助和機構式補助為主，中期則採取社區長期照顧和機構長期照顧的公助相輔相成之方式，而超高齡國家則需以長照保險發展共助來穩定財源。  This study focuses on community care in Taiwan and the United Kingdom. The comparative analysis was applied to explore the development process of community-based LTC in the United Kingdom and Taiwan from a welfare pluralism perspective. The study found that the United Kingdom and Taiwan have experienced similar policy ideas and practice shifts, that is, from “Care by the Community” to “Care within the Community”. In the time of change, the United Kingdom took place in 1993 and Taiwan in 2005. This study suggests that the national long-term care service strategies should be adjusted according to the degree of population aging. In the early stage, self-help community care bases and community care are mainly used, combined with institutional subsidies. In the medium term, community care, and institutional care provided by the government will be adopted. When reaching the super-advanced age, long-term care insurance will be needed to stabilize financial resources.