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題 名 | 以照顧津貼為導向的長期照顧制度對家庭照顧者的影響:以奧地利長期照顧制度為例=The Impact of Cash-Payment Oriented Care Systems on Main Carers: The Austrian Case |
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作 者 | 黃全慶; | 書刊名 | 朝陽人文社會學刊 |
卷 期 | 8:1 2010.06[民99.06] |
頁 次 | 頁233-261 |
分類號 | 548.2 |
關鍵詞 | 照顧津貼; 家庭照顧者; 奧地利; Long-term care; Austria; Cash for care; Care allowance; |
語 文 | 中文(Chinese) |
中文摘要 | 在先進國家的長期照顧體制中,奧地利是最以現金給付爲導向的國家之一,該國住民只要經有關醫療人員評定具照顧要求,即具照顧津貼的請求權,不需資產調查,也不過問爲何有照顧需求或其年齡。領取者可完全自由的決定怎麼使用這筆相對額度頗高的照顧津貼,而其財源主要爲稅收,津貼發放具有公民權利的意義。本文旨在探討在這種以照顧津貼作爲整個長期照顧制度核心的制度中,家庭照顧者將扮演何種地位?而長期照顧制度對家庭照顧者將產生什麼樣的影響?誰又是主要的照顧者? 透過文獻分析,我們發現該制度除具有減輕照顧的經濟負擔外,也充權給案主決定什麼是對他們最好的照顧方式,且因照顧津貼的發放亦增加了照顧需求者購買照顧服務的能力,促進了照顧服務產業的發展。且該制度因不需做資產調查,官方又無需介入直接提供服務,減少許多的行政成本。不過,家屬成員仍爲其主要之照顧者,且其中大多爲女性,也有爲數眾多的照顧需求者由外籍看護照顧。實施後主要問題在於主要照顧者社會保障不足、照顧品質較難以確保等,這也是該國近年來努力的方向,一方面將照顧者納入現有社會保險制度的保障中,二方面經由醫務、社工人員的訪視,以確保照顧品質,這些經驗都頗值得我國借鏡。 |
英文摘要 | The Austrian Long-term Care System is one of the most cash-payment oriented in the world. It offers every person who needs care at least 50 hours a month, a relatively generous cash payment without means testing or previously paid contributions. The receivers have freedom of choice over a large range of care possibilities. The System is universal and care is seen as a social right. The objective of this study is to investigate the development and outcome of the Austrian long-term care system since its introduction, which role will family- members play when care is needed in this "cash for care" system, and who are the main care-givers. Based on literature and document analysis, we found this system can relieve the financial burden of families who need care, it empowers them to decide which care patterns suit them, and the care market is promoted because families then have greater financial resources. It also minimizes the system's administrative cost. However, we also found that families, especially women, are still the primary care providers. There are also a large numbers of foreign carers employed by families in need. The major problems of this system are the lack of social security protection for family carers and the difficulty ensuring care quality. To counter such issues, Austria firstly grants care givers the right to social insurance and a large degree of compensation toward the costs. Secondly, doctors, nurses and social workers are employed to visit families in need to ensure care is being appropriated correctly. Taiwan can learn from Austria's experience. |
本系統中英文摘要資訊取自各篇刊載內容。