Using Delphi Technique to Explore Various Viewpoints on the Long-term Care Insurance

• Main Authors: Chien-Yu Chen, 陳建佑
• Other Authors: Sen-Yeong Kao
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/10191387094502662776

碩士 === 國防醫學院 === 公共衛生學研究所 === 102 === This study applies Delphi Technique to examine the attitudes towards long-term care insurance premiums of all types of insured persons. The participants include representatives from the long-term care industry, in-charge officers from government departments, scholars and professionals in related fields, non-governmental organizations in social welfare, and students in related majors from five universities. The survey questionnaire consists of 26 questions and 145 sub-items. After three rounds, the participants reach one hundred percent consensus, in which 71.7% of the sub-items (104/145) arrives at a "high degree of consensus"(Q0.5) and 28.2% at a "moderate degree of consensus"(0.5<Q1). Some significant findings are summarized as follows: 1. Questions regarding the national long-term care insurance policy. The participants have reached a high degree of consensus in sub-items such as:  Establish an adequate long-term care service system.  Strengthen the manpower and infrastructure of the long-term care service system.  Establish a sustainable financing system for the long-term care insurance policy.  Clarify benefits of social welfare and long-term care insurance.  Differentiate services covered by long-term care insurance and national health insurance.  Ensure a well-balanced geographical distribution of long-term care services resources  Disseminate information about the long-term care insurance policy.  Increase insurance subsidies for the disadvantaged.  Establish and provide more long-term services. 2. Questions regarding insurance eligibility A national compulsory insurance program has won consensus among the largest number of participants. 3. Questions related to long-term care insurance benefits (1) Types of provision ─ The consensus among the largest number of participants is that care services should be a primary means and cash payment as a supplementary one. (2) Range of benefits ─ Types of services which will receive befits include long-term care institutions, domiciliary care institutions, home nursing, nursing home, home care, daily care services, respite care at home, rehabilitation at home, meal service, temporary and short-term care, accessibility home improvement, adult foster care, and cash payment. 4. Questions related to financing long-term care insurance (1) Finance system ─ The consensus is that the long-term care insurance should be financially independent from the national health insurance but operated under a single unitary administrative system. (2) Premiums collection ─ The consensus is that premiums can be added to those of national health insurance. (3) Components of premiums ─ The participants have come to consensus over two factors: insurance salary and total household income before tax. (4) Premium calculation base ─ Total household income before tax has reached the highest degree of consensus among the participants. (5) The number of dependents ─ The actual number of dependents has reached the highest degree of consensus among the participants. (6) Contribution ratio ─ The participants have agreed on a ration the same as that of national health insurance. (7) Premium rate ─ The participants come to consensus that it is better to follow experts’ opinions. (8) Factors related to higher contribution rate ─ Higher income has reached the highest consensus. (9) Premium subsidies ─ Several criterions have reached high degree of consensus among the participants: severely disable persons, low-income households, the elderly, the unemployed, and veterans. 5. Questions related to copayment (1) Copayment rate ─ The highest level of consensus among the participants is that home care and community services should contribute 10% and institution services 15%. (2) Caps of copayment ─ Setting up regulations has the highest level of consensus. (3) Principles for the caps of copayment ─ The item of types of services have highest degree of consensus. (4) Copayment exemptions ─ Two criterions have reached a high degree of consensus, severe disability and low-income households. In conclusion, this study finds that long-term care insurance is highly valued by the Taiwanese people as expressed by the participants in this study. However, the participants who are employers differ significantly from others in their opinions about whom and what services eligible for subsidies. The researcher therefore suggests that a long-term care insurance plan should take this discrepancy into consideration. Keywords：Delphi Technique, Long-Term Care Insurance