臺灣人口老化，失能人口持續增加，對於長期照顧需求也隨之成長。在正式部門所提供的照顧中，居家服務是最基礎的骨幹服務，其提供失能者的身體照顧、家事服務和健康相關服務，是所有失能者執行日常生活所需的支持性服務，經由到宅的居家服務，讓需要服務者可以居住在原本的地方，是落實在地老化照顧理念不可或缺的服務。為了讓居家服務順利發展，公部門在政策推動歷程上有些轉變，除了隸屬於不同方案外，以補助時數與部分負擔為最主要差異，民眾使用服務從免費到需要部分負擔，這樣的差異是否會影響服務使用？故本研究著眼於在居家服務發展的歷程中，居家服務方案的轉變如何影響服務使用，透過訪談暸解服務使用者服務使用之變化，歸納影響服務使用之原因，提供未來規畫長照保險之參考。

As aging and disable population increasing, the demands of long-term care had increased. Home care services became one of the essential formal services for elderly. It provides supportive services including physical care, chores and health care services to achieve the goal of aging in place for elderly.Policy development of home care services came over some revisions, the most important change was the subsidy hours and co-payment. Users were not asked to pay for services at the beginning, and the implementation of co-payment policy may affect the willingness of utilizations for home care services. Therefore this study focus on the process of developing home care services and the influence of co-payment by qualitative interviews. Our government may take the opinions as reference when promoting relative long-term care policy and the development of long-term care insurance.