2020年4月

臺灣社區照顧關懷據點與需求人口之資源供需差異分析：應用地理可近性方法評估社區照顧資源配置妥適性
Disparity in Resource Allocation between Community Care Centers and the Demand Population in Taiwan: An Evaluation Conducted by Geographic Accessibility

研究論文 Article

曾明性, 吳慧卿
Ming-Hseng Tseng, Hui-Ching Wu

41-95

提高社區照顧關懷據點可近性，有助落實活躍老化政策。本文以2017年衛生福利部公開資料為資源提供點，65歲以上人口為需求人口，運用皮爾森相關係數、地理可近性、吉尼係數等方法，以縣市區域平均法、分區（同縣市使用）最近距離法及全島（跨縣市共享）最近距離法，進行資源供需差距分析。

研究發現，需求人口區位與據點位置與數量，存在資源供需差距。首先，從線性相關分析發現，皮爾森相關係數相當低，顯示資源供需區位分布相關程度低。其次，就據點服務負荷量，50％據點服務負荷量低於平均數，推論為位置偏僻或與其他據點鄰近，導致服務人口較少。第三，就取得據點服務最近距離分析，平均值最大縣市是花蓮縣、嘉義縣、南投縣、新竹縣、臺東縣，若將使用方式以全島（跨縣市共享）最近道路距離法評估，除臺東縣，其餘縣市最近距離都能縮短。最後，就需求人口據點擁有率（地理可近性分數），吉尼係數呈現不公平趨向，「中位數—平均數」皆負值，顯示縣市資源分配不平等。

Neighborhood social networks are influential for the elderly's health and well-being, and community-based care can enhance their participation in social activities. The geographic accessibility of com-munity care centers can reduce traffic inconvenience and advance the policy of active aging. This study focuses on the congruence between the demand population and the distribution of the supply of appropriate resources. The investigation applied the methods of Pearson's correlation, geographical accessibility, and the Gini coefficient to explore the service loading ratio of, resource ownership of, and nearest distance to community care centers. In this study, community care centers were held to be the supply points for the resources based on information derived from open data available in 2017. The demand population of the elderly was calculated according to the population aged 65 years or older in 2017. On the basis of these methods and data, our study provides a comparative analysis by using the administrative district average method, the nearest distance method of the same administrative district, and the nearest distance method of cross-county resource sharing.

The results obtained from this investigation demonstrate the inconsistency between the density of the demand population location and the geographical distribution of community care centers. First, Pearson's correlation coefficients show a low degree of conformity in the resource allocation's demand and supply. This finding indicates inconsistency between the resource supply and the demand population. Second, according to the amount of service loading, 50% of the centers show below-average values. These figures indicate that the locations are isolated or are adjacent to each other and are thus lacking in demand population. Third, based on the largest average of the nearest distances, the top five counties were found to be rural. Applying the nearest distance method of cross-county sharing of resources to reassess accessibility, all except Taitung County can shorten the nearest distance. These results support our research position of encouraging local governments to share community care centers. Finally, based on the service resource ownership rates of the demand population (geographic accessibility scores), the Gini coefficients are between 0.4~0.7, emphasizing the seriousness of the inequality between the resource supply and the demand population. 

In sum, the appraisal of spatial resource allocation is a key issue for governmental agenda-setting, whereby geographic accessibility assessments should examine both the demand side (e.g. elderly demand population, and rural/urban locations of administrative districts) and the supply side (e.g. distance factor, and capacity of community care centers). Geographic accessibility and the equality of resource distribution need to be examined synchronously in order to optimize the spatial locations of community-based care resources. Our study suggests that effective policy creation can allow the demand population, regardless of the area of the registered permanent residence, to make use of community care centers, and encourages local governments to cooperate and to share their community care resources. Through our policy suggestion of the cross-county sharing of resources, the inconsistencies between the demand population and the distribution of the supply of resources can easily be improved by enhancing the geographic accessibility of the elderly. This move can help the elderly to avail themselves of community care centers, and promote the execution of the "aging in place" policy goal.

社區照顧關懷據點, 社區照顧, 地理可近性, 資源配置, 空間不平等
community care center, community-based care, geographic accessibility, resources allocation, spatial inequality

社福社工, 公共衛生與社會醫學
Social Welfare and Social Work, Public Health and Social Medicine

https://doi.org/10.7014/SRMA.2020040002

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