以臺北市經驗為例探討喘息服務的供給與需求

Abstract

在長照2.0政策推動多年後，喘息服務仍面臨明顯的供需落差。本文以臺北市為例，旨在探討喘息服務供給與需求之間的落差現象。研究採半結構式的質性訪談法，訪談對象涵蓋12位喘息服務經驗的服務人員與家庭照顧者，深入剖析家庭照顧者的實際需求與各類型喘息服務在輸送過程中所遭遇的困境。

研究發現，喘息服務的供需落差可歸納出四個面向（1）資訊方面的落差：家庭照顧者的期待與其對喘息服務的認知理解，和實務運作的喘息服務不盡相同；（2）人力方面的落差：喘息服務的供給量難以回應家庭照顧者的需求量；（3）品質方面的落差：照顧服務員的服務品質參差不齊；（4）制度方面的落差：補助額度、給付標準與喘息服務類型的政策規劃，面臨制度設計與實務操作之間的矛盾。

根據上述研究結果，提出建議（1）資訊層面的落差：政府提供的喘息服務資訊需要積極整合與大力宣導；（2）人力層面的落差：擴增鐘點移工於喘息服務的適用範圍，以及調整喘息服務人力的薪資結構，以解決供需機制的不平衡；（3）品質層面的落差：強化督導與培訓機制的落實，提升與標準化照顧服務過程的品質；（4）制度層面的落差：喘息給付標準須依物價水準予以提升與修正，以促進服務人員的加入，並提高照顧產業願意加入喘息服務的誘因。

The Long-Term Care 2.0 policy has been promoted for several years in Taiwan, yet respite care exists disparities between supply and demand. This study uses Taipei City as a case study to examine the causes and challenges contributing to this imbalance. Drawing on semi-structured qualitative interviews with 12 respite care providers and family caregivers, the research explores caregivers’ actual needs and the challenges involved in delivering various types of respite services.

The findings identify four key dimensions of supply-demand disparity, each with corresponding recommendations: (1) Information disparity – A disconnect exists between family caregivers’ expectations and understanding of respite services and the realities of service delivery. It is recommended that the government integrate and actively promote accurate service information to enhance accessibility. (2) Manpower disparity – The existing workforce is insufficient to meet caregivers’ needs. Expanding the use of hourly migrant workers and improving wage structure are suggested to address this shortage. (3) Quality disparity – Variations in the quality of care provided by nurse aides indicate the need for stronger supervision and standardized training to ensure consistent service delivery. (4) Institutional disparity – Mismatches between subsidy policies, payment standards, and practical implementation reflect a misalignment between system design and practical operations. Revising the standard of the respite care payment to reflect current cost levels is proposed to attract more nurse aides and increase provider participation. The findings serve as a suggestion for policymakers to reconsider how resources are allocated within the Long-Term Care 2.0 framework. While efforts have been made to improve respite care services, some key practical issues remain unaddressed. Aligning policies more closely with practical experiences could help improve the effectiveness of service delivery.