臺灣長期照顧住宿式機構品質資訊公開之先驅研究

Abstract

研究背景：臺灣將於2025年進入超高齡社會，人口結構的改變使臺灣的高齡產業與長期照護的需求日益上升，提供住宿長照服務的單位及床數也逐漸增加，一般民眾在為家中需要長期照護的家屬選擇住宿式長照機構時，需要具有更多的客觀資訊作為考量的依據，在歐美國家長照品質資訊公開網站已運行多年。 研究目的：本研究參考國外文獻及現行公開資訊網站做法，依據目前臺灣市面上商用長照資訊系統次級資料，擷取可取得之結構面、過程面及結果面品質數據；篩選適合公開之品質指標，反映不同長照機構之照顧品質，提供民眾選擇長照服務單位時的依據；建構可供民眾瀏覽之長照機構照顧品質資訊公開網站。 研究方法：本研究透過研究及收集臺灣護理之家及老人福利機構於2021年間使用臺灣某長照資訊系統所登載記錄之資料，經由統計分析、參考國外文獻、公開資訊網站及美國CMS所使用的五星評等機制及計算評等，規畫住宿式長照機構品質資訊公開網站雛型。 研究結果：透過收集全臺灣30家護理之家及70家老人福利機構，總共68,132人次之資料，經由統計分析及計算評等後，給予人力資源及照護品質兩大類別之個別評等，再將其加以計算得出綜合評等，並將所有指標項目及說明進行整理，完成製作一個臺灣住宿式長照機構品質資訊公開網站雛型。 結論：本研究提出的公開資訊網站雛型，包含了基本資訊、圖形化的評等及呈現數據機制、詳細說明各項指標的表現及其重要性，期望能夠達到與國外同類型網站一致的目的：除了讓民眾能夠快速了解機構，也能促進機構經營者更進一步了解自身經營的策略與其他機構間的差異，向表現更好的機構標竿學習，使機構照護品質進入正面循環，提供住民的生活品質，創造更好的長照環境。

Background: Taiwan will enter a super-aged society in 2025. Changes in the demographic structure have increased the demand for elderly industries and long-term care in Taiwan. The number of long-term care facilities has also gradually increased. When family members choose long-term care facilities, they need to have more objective information as a basis for consideration. The long-term care quality information disclosure website in European and American countries has been running for many years. Objective: This study refers to literature and the current practice of open-data websites, and based on a current commercialized long-term care information system data on the market in Taiwan, to extract the available structural, process, and outcome quality measures; The quality of long-term care facilities provides the basis for the public to choose long-term care facilities; builds a public website for long-term care facilities care quality information that can be browsed easily by the public in Taiwan. Methods: This research collects data from nursing homes and long-term care facilities which are using a long-term care information system in Taiwan during 2021. With the processes of statistical analysis, literature reviews, utilizing the star rating methodology adopted by CMS in the United States. This research proposed a prototype of the quality information disclosure website of long-term care facilities. Results: By collecting data from 30 nursing homes and 70 long-term care facilities in Taiwan, total of 68,132 person, after statistical analysis and calculation of ratings, ratings in two categories of human resources and quality of care are given and then calculated. A comprehensive rating was obtained, and all quality measures and descriptions were sorted out to establish the prototype of a quality information disclosure website for Taiwanese long-term care facilities. Conclusions: The prototype of the quality information disclosure website proposed in this study includes basic information, a graphical 5-star rating and data presentation module, and a detailed description of both performance and importance of various quality measures. It is expected to achieve the same purpose as the Care Compare websites provided by CMS: in addition to allowing the public to quickly understand the facilities, it can promote the facilities to have a better understanding the differences of strategies between their own and other facilities, and benchmark learning from the better performing facilities, so that the long-term care facilities can provide residents with a better life quality and create a better long-term care environment.