鋪建勞工職災傷病後復健診治的軌道： 2022年《勞工職業災害保險及保護法》施行後認可職能復健機構的角色轉變

Abstract

本研究旨在探討《勞工職業災害保險及保護法》施行後，我國職能復健制度於政策推動與執行層面所面臨之挑戰，並透過檢視服務架構中所涉及的府際關係與公私協力機制，剖析其如何鋪建政策實踐之路。制度改革雖已啟動，且政府積極建構職災勞工重返職場的支持服務網絡，然在實務運作過程中，於制度整合與資源配置方面，仍存有諸多結構性瓶頸。其中，跨部會協作機制尚未健全，中央機關與認可單位的協力關係亦面臨諸多挑戰，影響政策的整體協同性與落實程度。此外，業務權責尚未統整，導致服務流程重疊、資源運用低效，甚至出現角色錯置的問題。整體而言，職能復健體系之實務執行與政策願景之間，仍存在顯著的落差，有待進一步釐清制度設計與協力運作間的調整方向。 為釐清上述制度困境，本研究採取質性研究方法，結合文獻分析與深度訪談，蒐集中央主管機關、財團法人機構、地方政府及認可單位等多元利害關係人之實務經驗與執行脈絡，據以分析制度運作中的挑戰與落差。本文並輔以日本、韓國及澳洲等國之制度作為比較分析的參照，藉以探索可供我國借鏡的改革方向與政策設計。本研究發現未來可透過優化資源配置機制、強化部會間的府際整合與垂直治理協調、推動「單一認可制度」以簡化行政程序、強化雇主於復工計畫中的主動參與角色，以及明確界定財團法人重建中心的角色與功能定位，降低資源重疊與制度摩擦，進一步提升行政效能與政策公信力。

This study investigates the implementation challenges of Taiwan’s vocational rehabilitation system following the enactment of the “Labor Occupational Accident Insurance and Protection Act.” Focusing on intergovernmental relations and public-private collaboration, the research explores how coordination mechanisms shape the delivery of return-to-work services. Despite ongoing institutional reforms and efforts to build a support network for injured workers, structural issues persist such as fragmented authority, duplicated services, and limited cross-agency cooperation hindering policy coherence and effective resource allocation. Using qualitative methods, the study draws on document analysis and in-depth interviews with stakeholders from central authorities, local governments, accredited rehabilitation agencies, and affiliated foundations. Cross-national comparisons with Japan, South Korea, and Australia provide additional insights for policy reflection. The findings suggest that future reforms should enhance interagency coordination, promote a unified accreditation system, clarify the governance role of foundations, and encourage greater employer engagement in return-to-work plans. These steps are crucial to reducing institutional friction and aligning administrative practices with policy goals.