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題名:長期照護財務規劃再評估與高雄市長照規劃研究
作者:鄭光峰
作者(外文):CHENG, KUANG-FENG
校院名稱:國立高雄科技大學
系所名稱:國際企業系
指導教授:李仁耀
學位類別:博士
出版日期:2019
主題關鍵詞:長期照護營業稅健保費單根自我迴歸財政預算Long-term careSales taxhealth insurance premiumUnit root testAutoregressive modelFinance budget
原始連結:連回原系統網址new window
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本論文首先回顧台灣長照政策沿革,了解長照計畫2.0的政策背景,再從長照計畫2.0的執行過程,透過時間序列分析,檢討政府對於長照計畫2.0的預算編列與支出。
結果發現,長照計畫2.0推行至今,由於涵蓋率與服務使用率的緩步增加及預算編列的不足,使得長照品質受到限制。長照計畫2.0執行至今,只能稱為「支持性長照政策」。若涵蓋率希望能達到原來政策目標,則財務缺口將迅速發生;未來如果將服務對象拓及外勞與機構服務,現有財務來源將無法支撐。
展望未來,若所需經費大幅增加,則財務改革有其必要性。若長照保險法通過,且採取健保隨收徵收方式,可機動調整費率來支付龐大經費。否則可透過提高營業稅進行因應,但建議政策修正配套方法須提早規劃。
此外,透過高雄市的執行長照計畫2.0的過程討論,可以了解長照政策在長照人力及政府組織,社區型日照中心的短缺,均有待修法和提早規劃因應,同時擴大社區的日照點及長照人力的養成,是未來每一縣市政府執行長照的課題。
This paper reviews the evolution of long-term care (LTC) policy in Taiwan, illuminates the development of the LTC 2.0, and critiques the government's approaches to budget allocation and expenditure for LTC 2.0 using time series analysis.
It was found that the quality of LTC was compromised due to the slow increase in coverage and service utilization as well as insufficient budgeting. LTC 2.0 could only be considered "supportive" since its launch. The financial gap may occur when the coverage rate meets the original policy objectives. More importantly, the financial sustainability may present challenges if the service targets are extended to foreign workers and institutional services.
Looking ahead, if the required funds increase significantly, financial reforms are necessary. If the long-term insurance law is passed and the health insurance collection method is adopted, the rate can be adjusted by manpower to pay huge expenses. Otherwise, it can be adjusted by raising the sales tax, but it is recommended that the policy amendments should be planned early.
In addition, through the discussion of execution process of Kaohsiung City in LTC 2.0, we can understand the shortage of LTC manpower, government organizations, and day-care centers in the community, all of which are subjected to revision and early planning. How to expand day care centers and long-term care manpower is the main concern of implementing long-term care policies in all county and city governments in the future.
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