一般護理之家督導考核結果研究－以中部某縣市為例

A Study on the Supervision and Evaluation of Nursing Homes-Cases from a County at Central Taiwan

陳南松(Nan-Song Chen) ； 潘忠煜(Chung-Yu Pan)

《台灣老年醫學暨老年學雜誌》 5卷4期 (2010/11) Pp. 277-286

https://doi.org/10.29461/TGG.201011.0005

摘要

目的：台灣地區人口老化速度持續上升，失能人口亦逐年增加。因社會環境、家庭結構與功能變遷使居住於長期照護機構的老年人比率逐年提高，老年人口快速遞增也使照護機構的需求與數量逐年俱增，依衛生署統計，護理之家數量從1997年29家至2009年373家成長了11.86倍。護理之家的經營現況與照護品質評估廣為各界關切，本研究係將衛生局對護理之家實施年度督導考核之結果進行分析以瞭解該縣市護理之家之照護品質。
方法：以臺中縣內所有護理之家計23家做為研究對象，設計督導考核品質評分表作為評量工具，內容分為：(1)行政管理(2)住民安全(3)服務內容(4)整體環境(5)特殊表現等五個部份。委請專家學者親赴各照護機構實地評核，以探討不同類型（權屬別、型態別、規模別）護理之家經營品質之差異，以無母數統計檢定(Mann-Whitney U test)進行結果分析。
結果：機構類型為公立機構，於住民安全、服務內容、專業會診、照護計畫等品質項目，其分數均顯著高於私立機構；經營型態為醫院附設型在住民安全、急救設備、整體環境等項目，分數顯著高於獨立經營型態；機構床數規模大小在各品質項目並無顯著差異。
結論：本研究提出護理之家督導考核常見之缺失、改善建議方向及後續輔導訪查重點。研究之結果期做為政府研擬老人照護、長照保險等相關政策和民間業者調整經營方向之重要參考。

關鍵字

護理之家 ； 照護品質 ； 督導考核

並列摘要

Objectives: In Taiwan, aging population as well as disabled population is rising in an ever-quickening pace. Rapid increase of elderly population triggers the demand for long term care facility that finds its mainstay in nursing home. According to the DOH (Department of Health) statistics, the number of nursing homes in Taiwan grew 11.86 times from 29 in 1997 to 373 in 2009. Therefore, it is of crucial importance to develop and implement effective assessment of nursing home quality and management efficiency.
Methods: In analyzing the quality of nursing homes in Taichung County, our study utilizes the evaluation results of the local health authority that are grouped into the following five major quality indicators: (1). Administration related data; (2). Residential safety; (3). Services provided; (4). Overall environment; and (5). Special performances. All the 23 nursing homes at Taichung County were incorporated in our analysis. The study categorized the 23 nursing homes according to ownership, affiliation and scale so as to compare their performance by statistical Mann-whitney U test.
Results: In terms of residential safety, services provided, professional consultation, and care plan, public nursing homes in general appear to perform better than their private counterparts. Hospital-affiliated nursing homes, on the other hand, outpace independent nursing institutions when residential safety, emergency equipments, and overall environment are concerned. There are no significant differences between the large-scale nursing homes (above 70 beds) and smaller-scale institutions by all quality indexes.
Conclusion: The results can be expected to serve as an important basis for nursing home managers to identify and correct potential problems and to make constant improvements in providing better care for their residents. We also hope that our study can provide the government with a valuable reference to refine eldercare policies.

並列關鍵字

nursing home ； quality of care ； supervision and evaluation