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從醫療政策與社會企業共同推動安寧居家療護-以結腸直腸癌為例

ADVOCATE HOME-BASED HOSPICE CARE THROUGH PUBLIC HEALTH POLICIES AND SOCIAL ENTERPRISES: AN EXAMPLE OF COLORECTAL CANCER

摘要


安寧療護設置的目的,是要維護生命末期病人全人化的照顧,提升病人與家屬較佳的生活品質。本研究使用健保資料庫中2009-2011年結腸直腸癌末期病患,在臨終前90天與14天的總費用分析中,使用安寧居家療護的住院費用比未用安寧療護者,分別節省15%和42%的醫療費用支出,故臨終前曾使用安寧居家療護,可以有效的減少無效醫療及健保費用支出,對末期病患是一項值得推動的政策。從商業保險角度,檢視現行保險商品對於安寧居家療護的保障缺口,建議新增安寧居家療護保障之保險金,可解決病患的財務負擔,提高安寧居家療護的利用率,企業與政府共同倡導良好的公共醫療政策,可提升醫療政策的效益。

並列摘要


The purpose of hospice care is to improve the quality of life of terminally ill patients, increase family care satisfaction. This study analyzed the end-stage colorectal cancer patients from 2009 to 2011 in the National Health Insurance Research Database. Hospitalization expenditure with respect to 90 days and 14 days before death for using home-based hospice care (HBH care) are 15% and 42%, respectively, less than those who do not use hospice care. Therefore, by advocating HBH care is a worthwhile policy of end-of-life patients, can reduce futile treatments and national health insurance medical costs effectively. From the perspective of commercial insurance, this study examines the current insurance products for the security gap of HBH. Accordingly, an additional commercial insurance product pays the HBH care benefit is suggested. This insurance benefits can reduce the financial burden of end-life patients and improve the HBH care utilization rate. Play the role of a social enterprise and advocate a good public medical policy together to enhance the common interests of the nation.

參考文獻


蕭雅倫、林明慧、黃怡璇、張曉婷、黃信彰 (2013)。子宮頸癌末期高齡病患接受安寧病房住院照護與急性病房住院照護之比較性研究-台灣健保資料庫分析。安寧療護雜誌,18(1),24-38。doi:10.6537/tjhpc.2013.18(1).3
翁益強 (2011) 。 安寧 居家 療護 。 健康世界 , 302 , 51-55 。doi:10.6454/HW.201102.0051
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陳雪姝、謝秋萍、李幸諭、蔡瓊玉、李哲瑋 (2015)。安寧療護使用天數對末期病人醫療資源耗用之影響。台灣公共衛生雜誌,34(4) ,413-423。doi:10.6288/tjph201534104039
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