進階搜尋


   電子論文尚未授權公開,紙本請查館藏目錄
(※如查詢不到或館藏狀況顯示「閉架不公開」,表示該本論文不在書庫,無法取用。)
系統識別號 U0026-1708201520532000
論文名稱(中文) 民間參與老人養護機構投資效益個案研究-以高雄市(市48)市場用地為例
論文名稱(英文) A study on the BOT case of nursing house in Kaohsiung City No.48 marketland as an example
校院名稱 成功大學
系所名稱(中) 建築學系碩士在職專班
系所名稱(英) Department of Architecture (on the job class)
學年度 103
學期 2
出版年 104
研究生(中文) 李育紋
研究生(英文) Yu-Wen Li
學號 N77021100
學位類別 碩士
語文別 中文
論文頁數 119頁
口試委員 指導教授-陳耀光
口試委員-曾亮
口試委員-蘇南
口試委員-文一智
中文關鍵字 民間參與  BOT  老人養護機構 
英文關鍵字 civic engagement  BOT  elderly care facilities 
學科別分類
中文摘要 根據衛生署2013年台灣地區主要死亡原因顯示,國人十大死亡原因的疾病類型以慢性疾病為主佔6成4。疾病結構已從早期的急性傳染病演變成今日以慢性病為主要死因,慢性病所帶來不同程度的失能,成為現在民眾接受醫療服務之主因。
隨著我國人口結構正快速進入高齡化社會,且近年來家庭結構轉變,婦女參與勞動率提高、核心家庭增多、青年人口逐年下降的趨勢中,造成家庭照顧人力明顯不足,以傳統家庭為中心的社會安全網已逐漸失去照護老人功能,而使家庭中老年人需交由機構來照顧。
但多數老人都希望能在自己熟悉的社區環境中安享晚年,加上入住養護機構老年人異質性強,使得老年人在機構中無法獲得完全的滿足,以致機構中老年人容易產生社會邊緣化、家人棄養等負面觀感。
從各國長期養護改革趨勢與我國社會福利發展趨勢可知,在長期養護需求不斷增加、對養護品質要求不斷提升且愈趨多元的壓力下,未來長期養護供應將朝向朝政府與民間共同負責與合作的方向發展。
本研究以高雄市為例,探討高雄市老人養護機構現況、需求與機構未來發展之趨勢,並模擬民間參與投資興建老人養護機構投資效益分析,評估以民間參與之興建方式,其基地選址、適法性、建築計畫、營運成本、營運收入等方面之評估,分析高雄市老人養護機構如何能符合社會福利的本質,並同時能夠維護商業經濟的投資利益,以期能提供更完善之機構照護服務。
關鍵字:民間參與、BOT、老人養護機構
英文摘要 Summary
The population structure in Taiwan is rapidly stepping into ageing society. In addition, in recent years, with the transformation of family structure, increase of women’s labor force participation rate, increase of core families, and gradual decrease of young population, there has been a significant lack of family caregivers. The traditional family-centered social safety nets have gradually lost the function of elderly care. Therefore, the elderly in families have to be taken care of by facilities.
According to the trend of reform of long-term care policies of various countries and the developmental trend of social welfare in Taiwan, under the pressure of increasing needs for long-term care, as well as increasing needs for improvement and diversity of care quality, it is necessary to develop future Build–operate–transfer (BOT) model of long-term care.
This study took Kaohsiung City for example to investigate the current status and needs of elderly care facilities in Kaohsiung City, as well as future developmental trend of facilities. This study also simulated the investment benefit analysis on civic engagement in investment in elderly care facilities to assess the construction method, site selection, appropriateness, architectural plan, operational cost, and operational income of civic engagement, as well as to analyze how elderly care facilities in Kaohsiung City conforms to the nature of social welfare and maintain investment benefits of commercial economy, in order to provide more comprehensive facility care services.
Keywords: civic engagement, BOT, elderly care facilities
Introduction
In recent years, with the rapid transformation of population structure in Taiwan in ageing society, as well as the transformation of family structure, the labor participation rate of women has increased, the number of nuclear families has increased, and younger population has gradually decreased, leading to the significant decrease in family caregivers. In addition, traditional family-centered social safety net has gradually lost the function of elderly care, and middle-agers and the elderly in families have to be taken care of by facilities.
This study took Kaohsiung City as an example to investigate the current status, characteristics, and trend of future development of elderly care facilities in Kaohsiung City. It is hoped that the research results can be provided as reference and direction for government policies and operation of care facilities to enable the elderly living in care facilities to receive proper care, improve management performance of facilities, and enable facilities to continue operating and providing more diversified services with higher quality.
The research methods used in this study are:
1. Literature Analysis
This study used literature analysis on relevant studies to preliminarily understand the problems encountered by elderly care facilities in Taiwan and the level of population ageing in Taiwan.
2. Simulation Analysis
This study selected one base in Kaohsiung City. After analyzing the conditions of the base, this study simulated the architectural space planning to assess conditions of base and analyze investment benefits. Based on the analysis results, this study judged the best model for private elderly facilities of public-private partnership.
Research and Conclusions
1. Trend of Ageing in Taiwan
The trend of change in age population (children, young adults, and the elderly) at three stages is shown in Table 2-2 .The population of young adults aged 15-64 (a.k.a. working-age population) will reach the peak by 2015 and start to decrease since 2016. In addition, the population of children will continue decreasing. Under the trend that elderly population continues increasing, elderly population will exceed children population by 2016. Compared with 2014, it is estimated that children population and young adults will decrease by roughly half by 2061 (decrease by 52.2% and 47.9%, respectively) and elderly population will increase by 1.6 times.
2. Average Accommodation Cost
The sources of operating income in Taiwan are mainly divided into two major parts: day care and bed care. Other sources include service income, government subsidies, interest income, donation income, and other operating income. This study referred to the standard of average charge of elderly welfare facilities in Taiwan and the sources of income of elderly care centers in Kaohsiung City to divide elderly care centers into elderly centers of medium quality and those of high quality, in order to establish indices for high quality elderly care centers in Kaohsiung City.
3. Investment Benefits of Premium Charging
This study used concession period of 30 years, 40 years, and 50 years to assess various financial evaluation indices, respectively (as shown in Cash Flow Chart in Appendix 3). The explanations are given as follows:
Conclusion
1. Advantages of Land Used for Market
The elderly care center in this study was established from the perspective of “ageing in place,” as well as the original intention of land used for traditional market. It is hoped that the objectives of “full utilization of land,” “sharing of land benefits,” and “sharing of resources” can be achieved to fully utilize values of urban lands and fulfill the concept of “ageing in place” of elderly care center.
2. Assessment on Investment Benefits of this Case showed Feasibility
The financial results of this BOT case showed that, the profit would be returned starting from Year 13. The NPV in Year 30would NT$ 167,539,723 (with premium charged), the IRR would be 10.45%, and the SLR would be 1.36. Therefore, this case is worthy of development.
3. Use of BOT Model to Develop Land Used for Market can Increase Government’s Revenue
The benefits of this BOT development case is average tax avenue of approximately NT$ 19,751,564 for 30 years. The benefits of the government in the first 30 years could reach NT$ 592,546,920, which is the tax revenue increased by the public resources provided by government.
論文目次 中文摘要
Abstract
誌謝
目錄
圖目錄
表目錄
第一章 緒論
1-1緣起與目的 1-1
1-1.1緣起 1-1
1-1.2目的 1-2
1-2 研究方法與架構 1-3
1-2.1研究方法 1-3
1-2.2研究流程架構 1-4
第二章 民間參與老人養護趨勢與問題
2-1我國老化趨勢與需求 2-1
2-1.1人口老化趨勢 2-1
2-1.2老化人口的困境與需求 2-4
2-2 我國老人長照政策與法令 2-8
2-2.1歷年政策與檢討 2-8
2-2.2長期照顧服務法 2-12
2-2.3長期照顧保險法 2-13
2-3我國長照服務供給 2-15
2-4照顧機構供給現況問題 2-17
2-4.1供給現況 2-17
2-4.2供給問題 2-18
2-5民間參與機構照顧之必要性 2-19
2-5.1政府政策與財務 2-19
2-5.2國內市場需求 2-20
2-5.3民間機構投資誘因 2-21
第三章 高雄市老人長照市場分析
3-1市場分析 3-1
3-1.1 市場結構 3-1
3-2高雄市老人長照市場需求 3-2
3-2.1 高雄市老化趨勢 3-2
3-2.2 高雄市失能人口數分析 3-4
3-2.3高雄市失能長照市場需求評估 3-6
3-3高雄市長照機構現況供給 3-7
3-4本研究標的市場定位 3-9
3-4.1本研究標的服務範圍人口分析 3-9
3-4.2服務族群 3-11
3-4.3經營模式 3-11
第四章 標的選擇與建築計畫
4-1開發標的選擇 4-1
4-1.1選擇市場用地緣由 4-1
4-1.2高雄市市場用地使用概況 4-1
4-1.3市場用地調查 4-2
4-1.4基地條件 4-4
4-2 市場用地多目標使用辦法 4-7
4-3 建築計畫 4-10
4-3.1 老人福利機構建築設立標準 4-10
4-3.2 養護機構空間設立標準 4-12
4-3.3 興建規模 4-13
4-3.4建築空間計畫 4-15
第五章 投資效益分析
5-1 參數設定 5-1
5-2 期初成本 5-5
5-3 營運成本 5-6
5-4 營運收入 5-9
5-4.1 養護住宿收入 5-9
5-4.2 養護服務收入 5-10
5-4.3 店舖租金收入 5-11
5-4.4 年總收入 5-12
5-5 投資效益 5-12
5-5.1 財務效益評估指標 5-12
5-5.2收取權利金投資效益 5-17
5-5.3本研究對政府之效益 5-18
第六章 結論與後續研究建議
6-1 結論 6-1
6-2 後續建議 6-2
參考文獻 i
附錄一、高雄市老人安養、養護暨長期照顧機構一覽表 附錄一-1
附錄二、2014年全臺百大優質老人照顧機構 附錄二-1
附錄三、現金流量表-收取權利金 附錄三-1
圖目錄
圖1-1研究流程架構圖 1-5
圖2-1台灣三階段人口變動趨勢示意圖-中推計圖 2-4
圖3-1本研究標的服務範圍圖 3-10
圖4-1基地位置圖 4-5
圖4-2基地現況圖 4-5
圖4-3(市48)市場用地地籍圖 4-6
表目錄
表2-1台灣地區人口結構統計表 2-2
表2-2台灣三階段年齡人口-中推計表 2-3
表2-3台灣55歲以上者之家庭組成表 2-7
表2-4臺灣近年來長期照護相關政策表 2-10
表2-5全國老人長期照顧、安養機構資源分布表 2-18
表2-6全國失能老人人口數與長期照顧、安養機構可供進住人數比較表 2-21
表3-1高雄市人口結構表 3-3
表3-2 2011-2060年我國失能人數之推估情形表 3-5
表3-3 2014年底高雄市各年齡層失能人口統計表 3-5
表3-4高雄市老人長照機構需求評估表 3-7
表3-5台灣地區與高雄市老人長期養機構數一覽表 3-8
表3-6高雄市老人養護機構現況一覽表 3-9
表3-7原高雄市各行政區老年人口數表 3-10
表3-8原高雄市各行政區老年人口結構表 3-10
表4-1原高雄市地區市場用地使用現況綜整表 4-1
表4-2原高雄市市場用地調查表 4-3
表4-3(市48)市場用地土地權屬明細表 4-6
表4-4高雄市前鎮區人口概況表 4-7
表4-5零售市場多目標開發使用項目表 4-8
表4-6土地使用強度表 4-13
表4-7建築空間計畫表 4-15
表5-1固定資產耐用年數表 5-2
表5-2五大銀行平均基準利率表 5-2
表5-3基本假設參數表 5-4
表5-4期初投資成本表 5-5
表5-5人事成本表 5-6
表5-6總營運支出成本表 5-8
表5-7百大優質老人照顧機構─平均收費標準(單位:元/人月)表 5-9
表5-8養護住宿收入表 5-10
表5-9養護服務收入表 5-11
表5-10店舖租金收入表 5-11
表5-11收入來源總表 5-12
表5-12效益評估指標說明表 5-14
表5-13財務評估指標評估標準表 5-15
表5-14收取營運權利金效益評估表 5-17
表5-15本研究對政府之效益評估表 5-18
參考文獻 論文
1.吳千里,我國長期照護機構法制之探討,東吳大學,法律學系,2008
2.潘韻如,民間參與台南市老人養護機構可行性研究,國立成功大學建築研究所,2012
3.張忠進,高雄地區老人安養護機構經營管理之比較研究─以高雄市仁愛之家、私立高雄仁愛之家為例,義守大學,管理科學系, 2001
4.黃筱薇,長期照護財源籌措方式之探討,國立中正大學,社會福利系,2000
5.賴榮郎,老人安養護機構經營管理之研究以彰化縣為例,南華大學,非營利事業管理研究所,2008
6.張忠進,高雄地區老人安養護機構經營管理之比較研究─以高雄市仁愛之家、私立高雄仁愛之家為例,義守大學,管理科學系, 2001
7.龔明聰,長期照顧機構服務產業發展之研究-以高雄市為例,國立中山大學,高階公共政策碩士班,2008

書籍與期刊
1.蘇怡菁,老年人的需求議題探討,家庭教育雙月刊第42期,2013
2.行政院衛生福利部老人狀況調查報告,2013
3.吳肖琪,臺灣老人福利政策與法令制度社會福利模式,從傳承到創新研討會,2011
4. 社區發展季刊:社論─長期照護體系之建構,衛生署長期照護三年計劃,2000
5.謝美娥,老人長期照護相關議題, 1993
6.李世代,內政部社區發展雜誌社,社區發展季刊─長期照護體系之建構:長期照護需求推估之探討,2000
7.高醫醫訊月刊第二十六卷第十一期,2007
8.高雄市95、96年度辦理失能老人居家服務業務情形統計分析,高雄市政府社會局,2008
9.「變更高雄市都市計畫區(原高雄市地區)市場用地(通盤檢討)案(第一階段)計畫書」,2013

網站
1.內政部社會司老人福利服務
http://sowf.moi.gov.tw/04/new04.asp
2.行政院衛福部
http://www.mohw.gov.tw/CHT/Ministry/Index.aspx
3.行政院國家發展委員會
http://www.ndc.gov.tw/
4.行政院公共工程委員會民間參與公共建設
http://ppp.pcc.gov.tw/PPP/index.do;jsessionid=8C7827E815F3D4A8A798B14317AC6C2F
5.高雄市政府都市發展局全球資訊網
http://urban-web.kcg.gov.tw/KDA/web_page/KDA010100.jsp
6.高雄市政府主計處
http://kcgdg.kcg.gov.tw/pxweb2007p/dialog/treelist/folder.htm
7.行政院衛福部統計處
http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312
8.行政院內政部統計處
http://www.moi.gov.tw/stat/
9.台灣碩博士論文知識加值系統
http://ndltd.ncl.edu.tw/cgi-bin/gs32/gsweb.cgi/login?o=dwebmge
10.中華民國統計資訊網
http://statdb.dgbas.gov.tw/pxweb/dialog/statfile9.asp
11.高雄市政府社會局
http://socbu.kcg.gov.tw/
論文全文使用權限
  • 同意授權校內瀏覽/列印電子全文服務,於2025-07-24起公開。
  • 同意授權校外瀏覽/列印電子全文服務,於2025-07-24起公開。


  • 如您有疑問,請聯絡圖書館
    聯絡電話:(06)2757575#65773
    聯絡E-mail:etds@email.ncku.edu.tw