The Projection of Disabled Population, Population with Dementia, and Care Workers in Need in Taiwan

研究目的：一、透過現有資料庫及設定若干假設以進行長照（潛在）需求人口（包括失能與失智者）及照顧服務員人力的推估。二、透過地理資訊系統將上述研究結果，進行空間面向的呈現與分析，並提出具體建議，以作為我國規劃長照保險政策之重要參考。研究方法：本研究採用盛行率法進行對未來長照（潛在）需求人口的推估，同時對於未來照顧服務需求時數與照顧服務員人力的推估，採用「以需求為基礎的估算法」進行。研究結果：一、根據本研究推估，在2011年全國所有年齡層一項以上ADL的人數為347,548 人（1.49%），其中65 歲以上者占 229,491人（9.00%）；若加上僅IADL 與僅失智者， 則 全國所有年齡層長照潛在需求人 數 更 將 上 升 至610 ,768人（2.62%）。二、高 齡女性的長照潛在需求人數超過男性，且隨著時間的推移，差距 將持續拉 大。三、照顧服務員人力推估呈現不足與不均的現象；但若是能將外籍看護工整合納入長照系統，則全國總共的照顧服務人力應可足夠。未來建議：一、透過長照服務網的建置與若干獎勵／鼓勵措施，讓照服員人力不足的地區能優先發展起來。二、儘速建置完整的長照資料庫，並確立跨部會管理的機制。三、儘速將外籍看護工整合納入長照系統，並將職前訓練規定納入相關法規中。四、儘速建立照服員與未來納入長照系統外籍看護工的在職訓練、定期證照檢覈等專業資格規範制度。Aims: This study uses databases and hypotheses to project the population in Taiwan who are likely toneed long-term care services in the near future (including disabled people and people with dementia), and the number of care workers required providing such services. This study also presents findings by Geographic Information System (GIS), and gives some suggestions for long-term care insurance policy-making. Methods: This study uses the prevalence method in projecting the population who will likely need long-term care services. A demand-based approach is used for the projection of the caring hours and amounts of care workers required. Results: Based on the projection of this study, there will be 347,548 people (1.49% of total population) with at least one ADL in 2011 in Taiwan. Among them, there will be 229,491 people aged 65 and above (9.00% of this sub-population). Including the population with only IADL and dementia, there will be 610,768 people (occupying 2.62% of total population) with long-term care needs in 2011 in Taiwan. In addition, the female elderly population with long term care needs exceeds the male population, and the difference between these two will keep increasing in the near future. Furthermore, based on GIS analysis, the amount of care workers will become insufficient nationwide in many areas, yet foreign care workers could serve within the long-term care system to make up this shortfall. Implications: This study gives four suggestions: (1) An increase in domestic care workers in some regions by the establishment of a long-term care services network having some incentives is necessary; (2) Construction of an integrated and comprehensive long-term care database will assist in confirming the mechanism of communication and policy-making for the different ministries affecting the long-term care field; (3) Increasing the foreign care worker involvement in the long-term care system, and implementing prevocational training regulations for them, should be addressed by articles of law related to the long-term care field, and (4) The establishment of vocational training regulations, and a license/certificate renewing mechanism for domestic/foreign care workers should be initiated immediately