影響台灣民眾長照需求之相關因素

目的:探討臺灣地區之人口、社會經濟、家庭結構等因素與人民長照需求之間的關係，有助於提供臺灣長照領域的相關政策建議及策略制定。方法:本研究通過橫斷式設計，利用2021年臺灣社會變遷基本調查計畫的數據，對18歲以上的1450名臺灣民眾的長照需求進行了分析。資料分析首先使用R統計軟體進行初步資料篩選與處理，接著以SPSS進行描述性統計和推論性統計分析。描述性統計部分，以次數分配和百分比呈現各變項在不同長照需求中的分布情況。推論性統計部分，透過卡方檢定檢測類別型變項在不同長照需求間的差異，並使用多項式羅吉斯迴歸探討各自變項與長照需求之間的相關性。結果:研究結果顯示，臺灣民眾的長照需求主要受到年齡、教育程度、目前工作狀況、婚姻狀況、地區等因素的影響。以下是具體的數據分析結果：長照需求的分佈：家中一個人辭職或休學照顧：97人（6.7%），雇用看護或外勞在家照顧：481人（33.2%），白天送去附近社區機構，晚上接回來：395人（27.2%），全天送去養護機構：477人（32.9%）。人口特徵分析：性別：女性佔55%，男性佔45%。年齡：18-39歲佔32%，40-59歲佔39.3%，60歲以上佔28.7%。教育程度：大學以上學歷者佔39.6%，高中職及專科佔38.2%，國中佔11%，國小以下佔11.3%。經濟和婚姻狀況：收入：個人月收入在3萬元以上者佔56.9%。婚姻狀況：已婚或有同居人者佔54.3%。地區：北北基宜桃竹苗佔49.7%，中彰投雲嘉南佔29.7%，高屏澎花東佔20.6%。相關性分析使用多項式羅吉斯迴歸分析各因素與長照需求之間的相關性，主要結果如下：年齡：18-39歲v.s.60歲以上者，選擇家中一人辭職或休學照顧的可能性較低（OR=0.40, p<0.001）。40-59歲v.s.60歲以上者，選擇雇用看護或外勞在家照顧的可能性較低（OR=0.38, p<0.001）。這反映了年輕人更注重個人職業發展和生活獨立性，而老年人更需要持續且專業的照護。教育程度：國小以下教育程度者v.s.大學以上者，更傾向於選擇家中一人辭職或休學照顧（OR=10.22, p<0.001）。這可能與低教育程度者的職業選擇有限和對專業照護認識不足有關。工作狀況：有工作者v.s.已退休者，選擇白天送去社區機構，晚上接回來的可能性較高（OR=1.20, p=0.403）。這可能是因為這類照護方式既能滿足照顧需求，又不會影響他們的工作和收入。婚姻狀況：已婚或有同居人者v.s.單身未婚者，更傾向於選擇雇用看護或外勞在家照顧（OR=1.60, p=0.002）。這可能是因為已婚者通常有更穩定的家庭支持系統，能夠承擔雇用看護的經濟負擔。地區：中彰投雲嘉南地區居民v.s.高屏澎花東地區居民，更傾向於選擇白天送去社區機構，晚上接回來（OR=1.60, p=0.021）。這反映了不同地區在長照服務供應和家庭照護文化上的差異。家庭結構：有常聯絡成年子女者v.s.無常聯絡者，更傾向於選擇家中一人辭職或休學照顧（OR=2.51, p<0.001）。這表明家庭成員間的密切聯繫在決定長照需求類型上起著重要作用。結論: 年齡、教育程度、目前工作狀況、地區等因素顯著影響臺灣民眾的長照需求。這些發現有助於制定更符合實際需求的長照政策，促進臺灣長照體系的完善與發展。建議未來政策制定時考慮這些關鍵因素，提升長照服務的整體效能和滿意度。

Objectives:To explore the relationship between demographic, socioeconomic, and family structure factors and the long-term care needs of people in Taiwan, aiming to provide relevant policy recommendations and strategies for the long-term care sector in Taiwan.Methods:This study employed a cross-sectional design, utilizing data from the 2021 Taiwan Social Change Basic Survey. The analysis covered 1,450 Taiwanese residents aged 18 and above. Data analysis involved initial data filtering and processing using R statistical software, followed by descriptive and inferential statistical analysis with SPSS. Descriptive statistics presented the distribution of various variables across different long-term care needs through frequency distribution and percentages. Inferential statistics employed chi-square tests to detect differences in categorical variables across different long-term care needs and used multinomial logistic regression to explore the relationship between independent variables and long-term care needs.Results:The study results indicate that the long-term care needs of Taiwanese people are mainly influenced by factors such as age, education level, current employment status, marital status, and region. The specific data analysis results are as follows:Distribution of Long-Term Care Needs: Home care by a family member who quits job or school: 97 people (6.7%)，Hiring a caregiver or foreign worker for home care: 481 people (33.2%)，Daytime care at a nearby community facility, returning home in the evening: 395 people (27.2%)，Full-time care at a nursing facility: 477 people (32.9%)。Demographic Characteristics:Gender: 55% female, 45% male.Age: 32% aged 18-39, 39.3% aged 40-59, 28.7% aged 60 and above.Education Level: 39.6% with a university degree or higher, 38.2% with a high school or vocational education, 11% with a middle school education, and 11.3% with primary school education or below.Economic and Marital Status:Income: 56.9% have a monthly personal income of over NT$30,000.Marital Status: 54.3% are married or cohabiting.Region:49.7% from Northern Taiwan (Taipei, New Taipei, Keelung, Taoyuan, Hsinchu, and Miaoli), 29.7% from Central Taiwan (Taichung, Changhua, Nantou, Yunlin, Chiayi, and Tainan), 20.6% from Southern Taiwan (Kaohsiung, Pingtung, Penghu, Hualien, and Taitung).Correlation Analysis The multinomial logistic regression analysis showed significant relationships between various factors and long-term care needs:Age:Those aged 18-39 are less likely to choose home care by a family member who quits job or school compared to those aged 60 and above (OR=0.40, p<0.001).Those aged 40-59 are less likely to hire a caregiver or foreign worker for home care compared to those aged 60 and above (OR=0.38, p<0.001). This reflects that younger people focus more on career development and personal independence, while older adults require more continuous and professional care.Education Level:Those with primary school education or below are more likely to choose home care by a family member who quits job or school compared to those with a university degree or higher (OR=10.22, p<0.001). This may be related to limited career choices and lack of awareness about professional care among those with lower education levels.Employment Status:Those currently working are more likely to choose daytime care at a nearby community facility, returning home in the evening compared to those who are retired (OR=1.20, p=0.403). This may be because this type of care meets the need for caregiving without affecting their work and income.Marital Status:Those who are married or cohabiting are more likely to hire a caregiver or foreign worker for home care compared to those who are single and never married (OR=1.60, p=0.002). This may be because married individuals usually have a more stable family support system and can bear the economic burden of hiring a caregiver.Region:Residents of Central Taiwan are more likely to choose daytime care at a nearby community facility, returning home in the evening compared to residents of Southern Taiwan (OR=1.60, p=0.021). This reflects differences in long-term care service supply and family caregiving culture across different regions.Family Structure:Those who have frequent contact with adult children are more likely to choose home care by a family member who quits job or school compared to those who do not have such contact (OR=2.51, p<0.001). This indicates that close family relationships play an important role in determining the type of long-term care needed.Conclusion:Age, education level, current employment status, marital status, and region significantly influence the long-term care needs of Taiwanese people. These findings can assist in developing long-term care policies that better meet actual needs, enhancing the overall effectiveness and satisfaction of long-term care services in Taiwan. It is recommended that future policy-making consider these key factors to improve the efficiency and satisfaction of long-term care services.