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
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:
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.