C級巷弄長照站整合照顧的現況、挑戰與機會－世界衛生組織整合照顧（ICOPE）服務層次之觀點

The current situation, Challenges and Opportunities to implement Integrated care in ＂ The Alley Long-Term Care Service C Station＂- The View of World Health Organization's ICOPE MESO level approach

10.6317/LTC.202008_24(2).0002

張語倩(Yu-Chien Chang)；陳雅美(Ya-Mei Chen)

長期照顧 ； 整合照顧 ； C級巷弄長照站 ； 世界衛生組織ICOPE方法 ； long-term care ； integrated care ； The Alley Long-Term Care Service C Station ； WHO Integrated care for older people (ICOPE)

長期照護雜誌

24卷2期（2020 / 08 / 01）

93 - 109

繁體中文

臺灣人口老化速度飛快，從高齡轉變為超高齡社會僅需7年，因人口結構改變，高齡者亦逐漸成為社會中主要的依賴人口，高齡社會所帶來的照顧問題是不可忽視的重要議題。臺灣遂於2016年實施長照2.0，強調在地老化和社區照顧的精神，推行ABC社區整體照顧服務體系，希望能讓高齡者回歸家庭與社區，其中C級巷弄長照站（C點）即是在地化長照服務輸送網絡的最前端，提供高齡者社區整合照顧服務。C點即將邁入第五年，有必要進行一個品質的檢核以作為未來指引。本文即以WHO倡議的ICOPE中觀層次評估方法檢核目前C點在提供整合照顧上的現況、挑戰與機會：發現目前C點與WHO所期盼的整合照顧仍有一段距離，原因主要為：（1）缺乏跨專業合作的機會，與AB的照顧資源網絡脫節、（2）缺乏具有專業知能的人力、（3）照顧功能的定位不明確。本文建議宜重新思考C點在ABC體系中的定位、整合跨專業的人力資源和照顧網絡、及強化C點整合照顧的功能，以提供高齡者以人為本的整合照顧模式。

Taiwan is the fastest aging countries in the world, it is estimated that only takes 7 years to transform from an aging society to a super-aged society. Due to the changes in the demographic structure, the older people would become the main dependent population in the society. The care problems bring by the aging society are important issues that cannot be ignored. In 2016, Taiwan implemented long-term care (LTC) 2.0, emphasizing the spirit of aging in place and community care, and implemented the ABC Integrated community care service system, it hoped that the older people could return to their families and communities. Among them, The Alley Long-Term Care Service C Station (C Station) was the forefront of the LTC service delivery network, provide community integrated care services for the older people. This article used the WHO ICOPE meso-level assessment method to evaluate the current status, challenges and opportunities of the integrated care in C Station. It found that there was a gap between the C Station and the WHO expect that. The main reasons were:(1) lacked of opportunities for interdisciplinary cooperation, disconnection with LTC resource network in AB system (2) insufficient human Resources and professional knowledge, (3) unclear position of care function. The suggestions of this research were as follows: (1)Reposition the role of C Station in the ABC system, (2) Integrate the interdisciplinary team and LTC resource networks,(3) Strengthen the integrated care function of C Station, to provide a person-centered integrated care for the older people.

1. World Health Organization (2019b). Integrated care for older people (ICOPE): Implementation framework guidance for systems and services. Retrieved from: https://www.who.int/ageing/publications/icope-framework/en/
2. World Health Organization (2015). World report on ageing and health. Retrieved from:https://www.who.int/ageing/events/world-report-2015-launch/en/
3. World Health Organization (2017). Guidelines on integrated care for older people. Retrieved from:https://www.who.int/ageing/publications /guidelines-icope/en/
4. World Health Organization (2019a). Integrated care for older people (ICOPE): Guidance for person-centred assessment and pathways in primary care. Retrieved from: https://www.who.int/ageing/health-systems/icope/en/
5. 內政部統計處（2020）．人口三段年齡組比率。取自：https://www.moi.gov.tw/chi/chi_site/stat/chart.aspx
6. 吳淑瓊,莊坤洋(2001)。在地老化:台灣二十一世紀長期照護的政策方向。台灣衛誌，20(3)，192-201。
7. 李易駿(2017)。小型長照服務單元的利基與挑戰：「巷弄長照站」的專業服務與籌辦想像．台灣社區工作與社區研究學刊。台灣社區工作與社區研究學刊，7(2)，183-198。
8. 孫智辰(2017)。社區照顧關懷據點轉型設置巷弄長照站的可能與限制－以臺南市資源不足區為例。台灣社區工作與社區研究學刊，7(2)，97-148。
9. 國家發展委員會（2020）．中華民國人口推估（ 2020 至 2070 年 ） 報告 。取自：https://pop-proj.ndc.gov.tw/upload/download/%E4%B8%AD%E8%8F%AF%E6%B0%91%E5%9C%8B%E4%BA%BA%E5%8F%A3%E6%8E%A8%E4%BC%B0（2020%E8%87%B32070%E5%B9%B4）%E5%A0%B1%E5%91%8A.pdf
10. 衛生福利部（2016）．長期照顧十年計畫 2.0（106~115 年）（核定本）。取自：https://www.mohw.gov.tw/dl-46355-2d5102fb-23c8-49c8-9462-c4bfeb376d92.html
11. 謝聖哲(2018)。從社區照顧關懷據點到巷弄長照站：挑戰與困境。台灣社區工作與社區研究學刊，8(1)，1-34。

1. 張智翔,林麗惠(2023)。當高齡教育專業走入C級巷弄長照站－談高齡健康促進的推動與可能。長期照護雜誌，26(1)，27-36。