A Study of long-term care needs and development for different urbanized areas in Pingtung County

This study mainly uses both quantitative and qualitative research methods to investigate future long-term care requirements and development of different urbanized areas of Pingtung County. In the part of quantitative research, this study conducts cluster analysis of different urbanized levels of 33 towns in Pingtung County. Then, estimation of number of disabled old people and rate of disability for the next ten years as well as resources inventory of long-term care is done according to different urbanized levels. For qualitative research, three focus groups are performed. Long-term care specialists and supervisors of Pingtung county are invited to share their observations of current long-term care service delivery of Pingtung County and suggestions for promoting future long-term care service policies of Pingtung County.Results of this study adopt three indicators: density of population, proportion of highly-educated people, and proportion of commerce and industry population. Through cluster analysis, 33 towns of Pingtung County are divided into seven different levels of urbanization. According to findings of this study, number of disabled old people of the whole Pingtung County in 2016 is estimated at 23,591 and this figure is expected to increase by 7,862, indicating a growth rate of 33.33%; furthermore, areas of different urbanization levels are different in population growth rate, age structure and sex ratio of disabled people. Through long-term care resources inventory, it is found that Pingtung City with high degree of urbanization shows the highest completeness of resource item establishment, and that there are rural-urban differences in completeness of long-term resource item establishment. Insufficient home service person or localized home help person is a difficult problem for areas of different urbanization levels. It seems that lower level of urbanization is associated with more serious shortage of daytime care center resources and more urgent need of community-based care resources. In addition, service use mostly shows polarized phenomenon of home service and institutional care. For areas of medium and low urbanization levels, service items such as home care, home rehabilitation, transportation service and barrier-free home environment improvement are not available because of obstacles caused by service delivery distance and service connotation.Based on above findings, suggestions for Pingtung County Government and the Central Government are proposed respectively. Suggestions for Pingtung County Government include: (1) actively promote self health management of community residents and freeze the disability rate of old people. （2） Develop programs for caregiver resource reengineering so that sufficient service persons are available. (3) Adjust measures to local conditions and cultivate diversified service providers. (4)Service contents should be integrated into local lifestyle so that care mode is more localized. (5) Provide more diverse supportive services in accordance with requirements of family caregivers of local disabled old people. (6) Service delivery should be based on principles of localization, communitization, convenience and mobilization to remove existing service obstacles. Suggestions for the Central Government include: (1) re-think about long-term care service performance indicators. (2) Achieve communication between health policies and long-term care polices of the Central Government. (3) Make the laws and regulations for setting of daytime care center more flexible, and actively establish community-based care resources. (4) Re-design home help items so that home help is more professional. (5) Re-consider smoothness and appropriateness of service delivery.