## 4 Research Results
### Discussion  
Many scholars have used a single model or tool, such as IPA, the I-S model, or the PEM, to explore projects that organizations need to improve. Each model has its advantages, but we think they are too subjective. Instead, it is best to use several models to repeatedly determine the areas that need to be improved before proposing an improvement strategy. The present study integrates the importance-satisfaction (I-S) model and service quality performance matrix (SQPM) to examine long-term care (LTC) service demands and satisfaction improvement. Japan's LTC system was established in 2000 to support older people with LTC demands and alleviate the burden of caregiving on family members [40]. People choosing to use LTC services, including in-home, facility, and community services, reduce their financial expenses and improve their quality of care [41]. Taiwan established LTCA 1.0 in 1998, and amended it to develop LTCA 2.0 in 2018. The implementation schedule in Taiwan was earlier than in Japan, but its effectiveness has \begin{table}
\begin{tabular}{c c c c c c} \hline
**No.** & \(\mathbf{\mu_{D}}\) & \(\mathbf{\mu_{P}}\) & \(\mathbf{P_{D}}\) & \(\mathbf{P_{P}}\) & **I-S Model** & **SQPM** \\ \hline
1 & 4.89 & 2.19 & 0.97 & 0.30 & To be improved & Prioritize improvement \\
2 & 4.67 & 2.67 & 0.92 & 0.42 & To be improved & Prioritize improvement \\
3 & 4.01 & 2.70 & 0.75 & 0.43 & Uniformat & Prioritize improvement \\
4 & 4.10 & 2.68 & 0.78 & 0.42 & Uniformat & Prioritize improvement \\
5 & 4.79 & 2.48 & 0.95 & 0.37 & To be improved & Prioritize improvement \\
6 & 4.33 & 2.61 & 0.83 & 0.40 & To be improved & Prioritize improvement \\
7 & 4.61 & 2.72 & 0.90 & 0.43 & To be improved & Prioritize improvement \\
8 & 4.72 & 2.97 & 0.93 & 0.49 & Excellent & Prioritize improvement \\
9 & 4.06 & 2.66 & 0.77 & 0.42 & Uniformat & Prioritize improvement \\
10 & 3.91 & 2.64 & 0.73 & 0.41 & Uniformat & Prioritize improvement \\
11 & 4.24 & 2.56 & 0.81 & 0.39 & To be improved & Prioritize improvement \\
12 & 3.99 & 2.65 & 0.75 & 0.41 & Uniformat & Prioritize improvement \\
13 & 4.34 & 2.64 & 0.84 & 0.41 & To be improved & Prioritize improvement \\
14 & 4.69 & 3.05 & 0.92 & 0.51 & Excellent & Prioritize improvement \\
15 & 3.51 & 3.92 & 0.63 & 0.73 & Surplus & Maintain \\
16 & 4.18 & 3.46 & 0.80 & 0.61 & Excellent & Prioritize improvement \\
17 & 3.58 & 3.37 & 0.65 & 0.59 & Surplus & Improve \\
18 & 3.32 & 3.86 & 0.58 & 0.71 & Surplus & Maintain \\
19 & 3.28 & 3.40 & 0.57 & 0.60 & Surplus & Improve \\
20 & 4.01 & 3.32 & 0.75 & 0.58 & Surplus & Prioritize improvement \\ \hline \end{tabular}
\end{table} 
Table 3: Relative values for I-S model and service quality performance matrix (SQPM). Figure 9: SQPM results. not been high. Therefore, the Taiwanese government and service providers must actively emphasize implementing the LTC system and making improvements regarding older adults' demands. Generally speaking, when time and resources are limited, it is not feasible to take comprehensiveness into account. When many projects must be improved and it is impossible to implement them at the same time, improvement priorities are developed [42]. In this study, if only the I-S model was used to examine LTC in Taiwan, then seven elements of the system would need to be improved: items 1, 2, 5, 6, 7, 11, and 13. However, if only SQPM were used, 16 elements would need to be improved: items 1-16 and 20. In other words, the outcomes are different when using different models. As mentioned earlier, Taiwan lacks sufficient LTC resources, so it is impossible to provide enough resources for all those who need care. To use resources efficiently, the I-S model and SQPM were integrated in this study to identify areas for improvement, and items 1, 2, 5, 6, 7, 11, and 13 were identified by both methods. From the empirical analysis, it was found that the average demand score is approximately 4 and the average satisfaction score is approximately 3, showing that older adults have a very high demand level, but their tendency for satisfaction is low.