根據世界衛生組織的標準，ㄧ個國家的六十五歲以上的人佔總人口數的7%時，就步入老年化的社會。台灣在民國八十二年，該人口數佔了總人口數7.1%，正式宣告進入老年化的社會。老年人口的比率還不斷的在增加中，到了九十三年底已達9.5%。而根據經濟建設委員會的研究，民國一百零五年之後，台灣人口的成長率將轉變為負成長，於民國一百四十年時，老年人口將達七百萬人，佔總人口數的35.5%。
    一旦進入老年化的社會，老人長期照護成為不可或缺的一環。本論文以社區網絡型態的長期照護，作為台灣老年化社會照護的市場策略研究。首先，在論文中，根據相關文獻與資料，探討人口老化的趨勢，老人照護問題與其長期照護的發展。接着，以PEST模式分析台灣大環境對老人長期照護市場的相關影響，並分析台灣現有的長期照護機構的種類與趨勢。最後，依策略定位方式，提出社區網絡型態的長期照護作為市場競爭模式，並以SWOT模式與五力分析模式分析社區網絡型態的長期照護的競爭優勢。
   當然，老人照護為社會福利的一環，政府扮演重要的角色。本論文主要目的是希望企業界能踴躍投入該市場，利用企業的管理能力及競爭，使老人得到合理，方便，尊嚴且人人負擔得起的照護方式。

Taiwan has been an aging society for years while its elderly people who aged 65 years old and over had over the 7.0% of the total population, officially entered the “aged society” as defined by the World Health Organization, 7.10% in 1993 and reached 9.5 % in 2004. According to a study from the Council for Economic Planning and Development, ROC, its rate will drastically ramp up to 20.4% by 2016 then birth rate will becoming negative, therefore the numbers of elderly people expect to 7 millions, means we have 35.5% of population is elderly people by 2051. 
    In this thesis we investigate a community-based service network as a long term care approach for aging society in Taiwan. First, we survey the global trend of elderly population growth and the background of long term care development. Second, we analyze the macro-environment in a process of PEST model and compare different approaches of current operations for the long term care business in Taiwan society. Third, we propose a localized scheme to provide a wide variety of long term care services by establishing a network of community-based service centers. We find that this strategic scenario is derived from both analysis of SWOT and five force model.
    Although, the care of elderly people is a cyclic of social welfare and government shall be playing a key role in these systems. This thesis is aimed to attract as many entrepreneurs as possible to invest in the long term care of elderly people. Privately-owned enterprises are much more competitive and efficient in the management of the business. Due to strong competition, the prices for this kind of service will become more reasonable. That is the consequence available for those who need.

Table of Contents
Abstract..................................................i
Acknowledgment...........................................iv
Abbreviations.............................................v
Table of Contents........................................vi
List of Tables.........................................viii
List of Figures...........................................x
Chapter 1 Introduction....................................1
1.1	Background.......................................1
1.2	Research Motivation and Objective................4
1.3	Research Methodology and Structure...............5
1.4	Research Scope and Limitation....................8
Chapter 2 Literature Review	...............................9
2.1	Demographic Evolution............................9
2.2	The Issue of Care for the Elderly People........14
2.3	Aging in Place..................................19
2.4	The Implications of Long Term Care..............22
Chapter 3 The Study of Macro-Environment of Aging Society   in Taiwan	................................................32
3.1	The PEST Model Analysis.........................32
3.2	Political Factor Analysis in Taiwan’s Aging Society..................................................36
3.3	Economic Factor Analysis in Taiwan’s Aging Society.............................................40
3.4	Social Factor Analysis in Taiwan’s Aging Society	................................................43
3.5	Technical Factor Analysis in Taiwan’s Aging Society..................................................48
Chapter 4 Modes of Operation for Long Term Care in Taiwan	................................................51
4.1	Resident Approach...............................58
4.2	Nursing Home Approach...........................61
4.3	Care Center Approach............................63
4.4	Home Caregiver Approach.........................65
Chapter 5 The Strategic Analysis for Community-Network of Long Term Care Sector....................................68
5.1.	Introduction of strategy analysis and Community-Network Approach.........................................68
5.2	Analysis of Community-Network of Long Term Care in SWOT..................................................72
5.3	Analysis of Community-Network of Long Term Care in Five Force Model......................................74
Chapter 6 Conclusions and Suggestions....................79
6.1	Conclusions.....................................79
6.2	Suggestions.....................................80
References...............................................81
List of Tables
1-1	Percentage of Population Aged 60 Years Old and Over by Selected countries, 2005 and 2050, at Medium Variant	3
2-1 	Twenty-two Indicator Conditions use to Determine Disability Severity Scores, with Their Disability Classes, and the Frequency of Care Needs as Rated by Health Professionals	11
2-2	Estimated Numbers of People Requiring Daily Care by Country Group and Selected Country and Year, Based on the Two Most Severe Global Burden of Disease Study Disability Categories (2000-2050)	12
2-3	Estimated Dependency Ratio Requiring Daily Care by Country Group and Selected Country and Year, Based on the Two Most Severe Global Burden of Disease Study Disability Categories (2000-2050)	13
3-1	Taiwan’s Government Legislation Development for Elderly People	37
3-2	Taiwan's GDP Growth Increase on Year Earlier and Sector’s Contribution	41
3-3	Population of Age Group in Taiwan (1990-2004)	43
3-4	Estimated Population of Taiwan (medium scenario, 2051)	44
3-5	Co-residence Situation of Elderly People in Taiwan, 2000	45
3-6	Necessity for Long Term Care in Taiwan, 2000	46
3-7	Measurement of Upgrade in Manufacture Sector (1985-2003)	49
3-8	Contribution of GDP by Sectors (1961-2003)	49
4-1	Rank of Ten Leading Causes of Death in Taiwan(1990-2001)	51
4-2	General Situation on Medical Resources	53
4-3	Long term Nursing Organization for Elderly People in Taiwan 2004	55
4-4	Nursing Organization for Elderly People in Taiwan 2004	55
4-5	Caring Organization for Elderly People in Taiwan 2004	56
4-6	Community Shelter and Residential Setting for Elderly People in Taiwan 2004	56
4-7	Rent Deposit of RUENEX Group, Dan Shui	59
4-8	Monthly Fee of RUENEX Group, Dan Shui	59
4-9	Monthly Expenditure of FORMOSA Group, Gui Shan	60
4-10	Authority Fee of FORMOSA Group, Gui Shan	61
4-11	Expenditure of Nursing Home in Taiwan by Selected	63
4-12	Aged people Living Alone Booked for Caring	65
4-13	Foreign Labor in Taiwan	66
5-1	Strengths of Community-Network of Long Term Care	73
5-2	Weaknesses of Community-Network of Long Term Care	73
5-3	Opportunities of Community-Network of Long Term Care	74
5-4	Threats of Community-Network of Long Term Care	74
5-5	Degree of Power of Suppliers in Five Force Model	75
5-6	Degree of Power of Buyers in Five Force Model	76
List of Figures
1-1	World’s Number of People Aged 60 and over 	2
1-2	Framework of Research 	7
2-1	Maintaining Functional Capacity over the Life Course	20
2-2	Mickey Mouse Mode of Care for Elderly People	26
2-3	Bicycle Mode of Care for Elderly People	27
2-4	Big –chains Mode of Care for Elderly People	28
3-1	Taiwan’s GDP Growth Increase on Year Earlier (1996-2005)	42

Chiang, Tung-liang (2002), “The Analysis of the Tendency   of Taiwan’s Healthcare Expenditure”, Taiwan Public Health, 2002, 21(3):157-163, Taiwan Public Health Association.
Council for Economic Planning and Development (2004), “Estimation of Population of ROC 2004-2051”, (93) 042.804, Jul. 2004 (in Chinese).
Gao, Ming (2000), “Be Action Urgently on Long Term Care for Elderly People”, Health Report (101) Oct. 1 2000, Department of Health, ROC (in Chinese).
Guo, Yin-Xue and Lin, Jia-Jun (2002), “Practice the Policy of “Aging in Place- Exploration of The Establish Network Service of Care for Elderly People in Peng-hu”, Department of Social Affairs, Ministry of Interior, May 31 2002 (in Chinese).
Harwood, Rowan H.; Sayer, Avan Aihie and Hirschfeld, Miriam J. (2004), “Current and Future Worldwide Prevalence of Dependency, Its Relationship to Total Population, and Dependency Ratio”, Bulletin of World Health Organization.
Hirschfeld, Miriam J. (1999), “Home-Based and Long Term Care, Social Change and Mental Health”, Home Care Issue and Evidence, World Health Organization.
Household Census (2000), Directorate-General of Budget, Accounting and Statistics, Executive Yuan.
HU, Yow-Hwey (1995), “The Support System of Community Long Term Care: Demands and Management Issues Related to Paid Helpers, Non-Paid Helpers and Support Network”.
Hu, Yow-Hwey and Chou, Yah-Jong (2000), “The Cultural Politics of the Asian Family Care Model: Missing Language and Facts”, collected in “Who Should Care for The Elderly?”, Singapore University Press, 2000.
Huang, Yuan-Xie (2003), “The Foundational Conception of Community-Based Care”, collected in “Strategic Development of Community-Based Care”, Committee of Long Term Care, National Health Research Institutes, March 2003 (in Chinese).
Hugman, Richard (2000), “The Value of Old Age in Modern Society: Social Responses to ‘Elder Abuse’”, collected in “Who Should Care for The Elderly?”, Singapore University Press, 2000.
Kending, H. and Hashimoto, A (1992), “Family Support for The Elderly”, Oxford University Press for The World Health Organization.
Kending, Hal (2000), “Change and Family Bonding in Australia”, collected in “Who Should Care for The Elderly?”, Singapore University Press, 2000.
Koyano, Wataru (2000), “Filial Piety, Co-residence, and Intergenerational Solidarity in Japan”, collected in “Who Should Care for The Elderly?”, Singapore University Press, 2000.
Lee, Sang-Hyop and Mason, Andrew (2004), “Population Aging and The Extended Family in Taiwan – A New Model for Analyzing and Projecting Living Arrangement”, Demographic Research, Volume 10, Article 8. May 12 2004.
Li, Shi-Dai (2003), “Decentralization Strategy and Tactics for Long Term Care Access to Community”, collected in “Strategic Development of Community-Based Care”, Committee of Long Term Care, National Health Research Institutes, March 2003 (in Chinese).
Lin, Qing-Xuan (2002), “The Policy of Long Term Care for Elderly People – The Views of Government Intervention Analysis”
Liu, Eva and Wong, Elyssa (1997), “Health Care for Elderly People”, Provisional Legislative Council Secretariat, Research and Library Services Division, Hong Kong, Oct. 25 1997.
Liu, William T. and Kendig, Hal (2000), “Critical Issues of Caregiving: East-West Dialogue”, collected in “Who Should Care for The Elderly?”, Singapore University Press, 2000.
Mellor, J.P. and Hebb, Chris (2004), “Aging In Place Position Paper”, Rose-Hulman Institute of Technology.
Porter,Michael E. (1996) “What is Strategy?”, Harvard Business Review, November-December 1996, pp. 61-70.
Sussman, Marvin B. (2000), “The America Experience, Family Change and Family Bonding: Conceptual and Policy Issues”, collected in “Who Should Care for The Elderly?”, Singapore University Press, 2000.
The Standard of Installation for Elderly People of Care Institution (1981), Department of Social affairs, Ministry of Interior.
Three Years of Plan of LTC for Elderly People (1998), Department of Health.
United Nations (2005), “World Populations Prospects, The 2004 Revision, Highlights”, ESP/P/WP.193, 24 February 2005, Department of Economic and Social Affairs, Population Division.
Walker, Alan (2000), “Sharing Long Term Care between Family and The State- A European Perspective”, collected in “Who Should Care for The Elderly?”, Singapore University Press, 2000.
World Health Organization (1999), “Men Aging and Health: Achieving Health Across the Life Span”, April 1999.
World Health Organization (2000), “Home-Based Long Term Care”, Report of A WHO Study Group. 
World Health Organization (2002), “Active Aging: A Policy Framework”, A Contribution to Second Untied Nations World Assembly on Aging, Madrid, Spain, April 2002.
World Health Organization (2002a), “Current and Future Long Term Care Needs”, An Analysis Based on the WHO Study, The Global Burden of Disease, The Cross-Cluster Initiative on Long Term Care.
Wu, Shwu-Chon and, Chuang, Kun-Yang (2001), “Aging in Place: the Direction of Taiwan Long Term Care Ppolicy in the 21st Century”, Taiwan J Public Health, 2001；20(3)：pp. 192-201.
Ye, Li-Li (2003), “The Background of Development of Community-Based Care”, collected in “Strategic Development of Community-Based Care”, Committee of Long Term Care, National Health Research Institutes, March 2003 (in Chinese).
Zhan, Qi-Xian (1998), “The Current and Development of Medical and Care for Elderly People in Taiwan”, collected in “The Challenge of Coming Aging Society”, The Seminar of Care of Elderly People in Asian Pacific, pp. 16-17 (in Chinese).