高雄地區居家照護實施情況及其病人特徵之研究

A Study of Home Health Care Services and Characteristics of Patients in the Kaohsiung Metropolis Area

劉慧俐(Hui-Li Liu) ； 黃培琳(Pei-Lin Huang) ； 楊志良(Chih-Liang Yaung)

《中華民國公共衛生學會雜誌》 12卷2期 (1993/06) Pp. 191-201

https://doi.org/10.6288/JNPHARC1993-12-02-08

摘要

本研究探討南區以護理師護士公會爲基礎之居家照護三年來之業務。目的爲了解居家照護患者的來源；並分析居家照護病人的特本研究探討南區以護理師護士公會爲基礎之居家照護三年來之業務。目的爲了解居家照護患者的來源；並分析居家照護病人的特徵及疾病性質，進而探討居家照護實施情形。結果發現三年來的收案個案呈不穩定增長，主要來源皆多透過「醫院聯擊」，而聯擊案未收案的主要原因是「家屬因經濟因素考慮，而未再聯絡」。個案以女性居多占52.2%，且多數是65歲以上老人(70.6%)，他們多不識字(36.1%)但有宗教信仰(73.9%)，大部份是本省籍(67.8%)，近36%的個案是鰥寡、離婚及未婚者。具公保居家照護給付條件近半數(42.8%)且多數的個案(87.7%)有家人配合照顧；在疾病診斷方面，以腦血管疾病患者居多46.1%而依診斷群分析則糖尿病、高血壓的病患亦不少；案家分佈區域，以公會所在的苓雅區最多占28.3%，外縣市的個案主要是鳳山市。在居家訪視服務實際需求方面，「心理支持」尤多於「生理服務」；居家護理師依責任區來分派個案，其交通時間約佔訪視時間二分之一；非公保給付患者每次需自付千元左右之費用，是公保患者的五倍。此外，並建議建全轉診制度，加強民眾及醫護人員連續性照顧的概念，爭取保險居家照護給付，及其它社會制度之配合，是拓展居家照護業務首要考量者。慢性病患需長期醫療照護，對主要照顧者負荷之關懷，及協助建立支持體系是需要的。又規劃居家照護記錄、身體評估方式，以作爲評鑑居家護理人員工作之準則亦急需發展。另從社區的觀點來發展居家照護，當有助於服務的成本效益。

關鍵字

居家照護 ； 長期照護

並列摘要

The purpose of this study was to evaluate the three-year, association-based home health care program which was launched in March 1988 in the Kaohsiung Metropolitan area. Specifically, we wanted: 1) to understand the source of patients home health care services; 2) to analyze the demographic characteristics of the patients and their disease patterns; and 3) to evaluate the efficacy of the program. A total of 441 communicating cases and 180 visiting patients have participated during the past three years. All records were reviewed, and the findings are summarized below. The number of annual cases has increased unevenly, with most patients being referred by hospitals. Demographically, 52.2% of the patients were female, 73.9% were more than 65 years old, 36.1% were illiterate, 73.9% were religious, and most were widowed, divorced or single. As for the source of payment, 42.8% of patients were ensured government employees, and 87.8% were cared for by their families. About half, 46.1%, of the patients had CVA (write out). Most had multiple diseases; 28.3% of the patients lived at Linya Ch'u, a. The demands of the home health services were focused on treating psychological problems. The nurses' working areas were assigned by districts, and the travel time took half of the visiting time. Noninsured patients paid about one thousand dollars per each visit; five times more than the insured. The possible causes for this are discussed, and some suggestions for home health care are proposed.

並列關鍵字

Home Health Care ； Long-Term Care