居家物理治療服務利用影響因素之探討－以臺北都會區失能者為例

Factors Associated With Home-Based Physical Therapy Utilization Among Disabled Community Dwellers in Taipei Metropolitan Region

李宜玲(Yi-Ling Li) ； 李世代(Shyh-Dye Lee) ； 曹昭懿(Jau-Yih Tsauo) ； 胡名霞(Ming-Hsia Hu)

《物理治療》 43卷3期 (2018/09) Pp. 215-228

https://doi.org/10.6215/FJPT.201809_43(3).0003

摘要

背景和目的：以大溫暖十年長期照顧計畫之施行經驗，分析居家物理治療(home-based physical therapy, HPT)服務利用的影響因素。方法：對2012年臺北都會區（臺北市及新北市）HPT資料庫進行次級資料分析，個案需符合長期照顧管理中心收案標準且接受2次以上之HPT介入。藉描述性分析、雙變項相關及多元迴歸等方法，分析個案之社會人口學資料、健康功能狀況等變項對HPT介入次數的影響。結果：接受HPT且符合收案標準個案共717位，平均介入5.4 ± 3.2次。透過多元迴歸分析發現，全部變項具16.4%的解釋力，社會人口學變項（包含個人與環境因素）影響大於健康功能狀況變項。具顯著解釋力之變項為年齡、性別、中（低）收入戶、意願、住家是否需爬樓梯與身體感覺功能。結論：較年輕、男性、中（低）收入戶、意願較高、住家需爬樓梯與感覺功能異常之個案，HPT介入次數較高。本研究結果有助於瞭解影響個案接受HPT的因素，可協助HPT制度規劃、服務體系的建構與誘發服務輸送，以支持失能個案發展更獨立的生活。

關鍵字

失能 ； 居家物理治療 ； 服務利用 ； 長期照護 ； 居家健康照護

並列摘要

Background and Purpose: To analyze the factors influencing the utilization of home-based physical therapy (HPT) services in the Ten-Year Plan for Long-term Care. Methods: Secondary data from the HPT database of the Taipei Metropolitan Area (Taipei City and New Taipei City) in 2012 were analyzed. Inclusion criteria were: (1) the clients met the reimbursement criteria set by the Care Management Center of the two cities; (2) each client received at least 2 sessions of HPT intervention. The influence of socio-demography and health-functional status on the number of HPT intervention was analyzed by descriptive analysis, bivariate correlation and multiple regression analysis. Results: A total of 717 clients were included, with an average of 5.4 ± 3.2 sessions. Multivariate regression analysis revealed that all variables had an explanatory power of 16.4%, and socio-demographic variables (including personal and environmental factors) had greater impact than health-functional status variables. The number of visits was mainly influenced by age, gender, social welfare status, willingness, housing environment and physical sensory function. Conclusions: The clients who were younger, male, middle (low) income households, higher willingness, stair climbing or sensory dysfunction received more HPT visits. The results might help to construct a more efficient mode of needs assessment for HPT and to facilitate better needs-based service delivery, in turn to reduce dependency in activities of daily living in HPT service users.

並列關鍵字

Disability ； Home-based physical therapy ； Utilization ； Long-term care ； Home health care