榮家長期照護系統自負盈虧之可行性研究

Abstract

基於榮家住民老化凋零，並配合內政部為滿足高齡化社會下老人安養需求規劃推動十年長期照顧計畫等外因內緣情境，榮家之經營將配合政府政策調整，而對於榮家財務機制之相關研究尚屬起步階段。因此，本研究希望運用財務分析技術，瞭解榮家在作業基金制度下自負盈虧之可行性。 由榮家之歷史脈絡及經營現況了解，榮家的業務雖已部分委外，但其業務範圍涉及公權力之行使，然為因應經營發展之困境與自負盈虧之挑戰，由傳統公務預算體制改設作業基金型態營運，成為經營轉型之最佳選擇。 為進一步了解榮家在作業基金制度下自負盈虧之可行性，本研究在以符合入住條件榮民及非榮民長照者為客源之先決條件下，透過情境分析方法，以「是否增床」、「榮家床位是否維持」等兩變數，進行四種模擬情境之財務分析，分別設算在各種情形下之床位使用情形、可否達成全面（含折舊）或部分(不含折舊)損益平衡、現金流入及流出情形、以及資本支出投資效益等財務資訊。 透過各種情境之財務分析，本研究進一步推估榮家未來發展之可能情境與最佳情境，並提出由「現況不作為」下之最可能情境，至「必須有所投入才能達全面損益兩平目標」之最佳情境之轉型建議，希望提供退輔會未來在執行榮家轉型策略之參考。

Facing the reality that veterans living inside the veterans homes are aging, and that, because of the need to satisfy the demand of home care for aging citizens in the senile society, the Ministry of Interior Affairs is pushing a 10-year long term care project, the management policy of veterans home will have to adjust to that of the central governmental policy. However, the related studies on the veterans homes financial mechanism are still in the initial stage. Therefore, this study is aimed to find out, through technical analyses, the feasibility on the budget accountability of VAC veterans homes under operational fund system.

The historical and current management of veterans homes shows that even though some of their operations have been outsourced, the execution of them is still of government power, and so, to cope with the management difficulties and the challenges of budget accountability, the evolution from the traditional governmental budgeting mechanism into the operational fund budgeting should be the best choice in their management model change.

To further understand the feasibility on the budget accountability of VAC veterans homes under operational fund mechanism, this study targets on two subjects: the veterans eligible to be home-cared, and those non-veterans waiting to be long-term cared. Under the methodology of scenario analysis, with two variations: ‘Should more care-beds be added’ and ‘Should the veterans homes’ care-beds be kept the same’, four finance scenario analyses are conducted. Hypotheses are made to review that under each scenario how care-beds are used, if an overall (including facility depreciation) or partial (excluding facility depreciation) budget balance can be achieved, what the results of cash in-flow and out-flow are, and what the financial information of capital expenditure and investment effectiveness shows, etc.

Through the various finance scenario analyses, this study will further evaluate on the possible and the best scenario of the future development of veterans homes, and make model change proposals on the most possible scenario in which no actions should be taken, and the best scenario in which input should be done in order to achieve a budget balance, for the VAC veterans homes to make decisions on their future model change strategies.