A Perceptual Gap Analysis of Service Quality Perceptions in Home-Based Long-Term Care Service Centers

Background: As Taiwan transitions into a super-aging society, the government has launched "Long-term Care (LTC) 3.0," a policy initiative that marks a strategic shift from service expansion to integrated quality verification, digital oversight, and social resilience. This transition demands a robust quality verification mechanism. Ensuring perceptual consistency between service providers and external evaluators is critical for systemic fairness and sustainable service quality. Objective: This study utilized a two-dimensional gap analysis to examine the discrepancy in service quality benchmarks between home-based LTC center managers and assessment committee members, identifying critical divergence zones for institutional improvement. Methods: A cross-sectional evaluative study was conducted, involving center managers (evaluatees, n = 50) and external experts (evaluators, n = 28). The data were collected via a structured instrument covering 20 consensus benchmarks. Results: Significant perceptual gaps were identified across all dimensions (p < 0.001), with "Professional Care Quality" exhibiting the largest effect size (Cohen's d > 1.5). Benchmarks with low external scores but high internal ratings were categorized into the "Overestimation (Management Blind Spot)" quadrant, signaling a systemic overestimation bias in administrative and clinical risk management. Conclusions: This study provides empirical evidence for the refinement of LTC 3.0 assessment systems. The results offer a strategic roadmap for policymakers to enhance organizational resilience by transitioning from subjective self-perception to objective, data-driven quality management through the two-dimensional gap model.