目標：本研究運用雙重困境觀點、老年均質化及持續不平等論點，檢視台灣不同省籍老人的長期照護需要之差異及省籍隨歷史時間推移之變化趨勢。方法：本研究利用「台灣地區中老年身心社會生活狀況長期追蹤調查」，歷時十四年的資料，以線性混合模式進行分析，將隨機效果納入模式之中。結果：研究發現，未控制社經變項時，本省籍老人的長期照護需要項目較多；在控制社經地位的差異後，發現省籍之間的長期照護需要差異不僅持續存在，即是將歷史時間及健保實施因素納入考量，而且隨著歷次調查時間的推移，本省籍老人的長期照護需要項目每年較外省籍老人多0.019項，表示省籍的差異出現擴大的趨勢，進入老老人階段後更加明顯，也就是長期照護需要差距在生命歷程最後階段更加擴大。結論：我國不同省籍老人的長期照護需要差距符合雙重剝奪觀點的論述，未來在規劃與執行老人健康與社會政策時，需考量族群與時間因素對老人長期照護需要造成的影響，且應特別關注本省籍老人在使用健康及長期照護資源的可能阻礙，進而排除服務使用的阻礙因素。

Objectives: From the perspectives of double jeopardy, aging as leveler, and persistent health inequality, this study examined the trends in long-term care needs of native Taiwanese and Mainlanders in Taiwan. Methods: Data used in this study were collected by the Bureau of Health Promotion, Department of Health in 1989, 1993, 1996, 1999 and 2003. A linear mixed model was applied for trend analysis. Results: Without controlling for independent variables, the long-term care needs of the native Taiwanese elderly were greater than those of elderly Mainlanders. After controlling for the socioeconomic and health status of the respondents, and
considering the implementation of health insurance over the period of 1984 to 2003, the disparity became greater over time. The native Taiwanese elderly seemed to be more vulnerable to disability than their counterparts, the Mainlanders. Furthermore, the disparity in long-term care needs between the elderly Taiwanese and the elderly Mainlanders will continue to grow as the lifespan of the elderly steadily increases. Conclusions: This study supports the “double jeopardy” hypothesis. The results also suggest that public policymakers must understand that the elderly in different ethnic groups face various barriers to receiving health care and long-term care in our society.