長期照顧體系應該由社政或醫療衛生體系主導一直是台灣社會福利與公共衛生學界長期以來爭辯不休的議題。行政院自106年起正式推動的長照2.0，初期是由社政推動，強調的是社區整體照顧模式。具體執行方案就是長照ABC。本研究希望透過兩個個案的比較，參照MCOs理論觀點，分析由社會福利團體或醫療機構擔任長照A級社區整合型服務中心，對於服務供給的整合以及長照使用者滿意度是否出現差異？社會照顧或是醫療照護驅動模式的長照2.0 ABC的整合照顧程度是否存在系統性的差異？這個比較研究將藉由焦點座談法與深度訪談法等質性研究歷程蒐集資料，參照MCOs觀點建立的研究架構，進行分析與歸納，研究結論一方面，將對臺灣社區整體照顧服務體系的建立，提供未來政策修訂的參考依據。另一方面，將對整合醫療照護與社會照顧資源的機制與模式，提供學術研究和實務工作的參考。 Should the long term care administrated by social welfare or medical sector is an ongoing dispute among the scholars and policy analysts of social welfare and public health in Taiwan. The Long Term Care (LTC) 2.0 program has been pushed by the Administrative Yuan since 2017, which had been initiated by social welfare sector as social care model and then shifted to medical sector at the Ministry of Health and Welfare (MoHW). The ABC model is expected to establishthe community care units in the different community level and make the LTC more accessible to those who in need. Based on the Managed Care Organizations (MCOs) idea developed by integrated care approach, this research aims to compare two models for integrating social and health care implementing LTC 2.0 at Taichung City Gov't: welfare-driven and medicine-driven integratedcare model. The former model is represented by the Da-Gia District and the later by the Middel-East District at Taichung. It will be examined if there exists the systematic differences in terms of user satisfaction and degree of integration between social and medical care. If yes, what is the mechanism behind this two models. Using the focus group and depth interview qualitative research methods, an analytical framework based on MCOs will be elaborated. This research program is expected to make useful policy advice to establish the comprehensive community care program in Taiwan. On the other hand, the local experimental implementation experience developed at Da-Gia and Middle-East District will also make contribution to the academic discussion of integrated care in Taiwan andinternational long-term care field.
