台灣地區之出院準備服務－試行計劃成果分析

Discharge Planning in Taiwan - An Analysis of Demonstration Projects

戴玉慈(Yu-Tzu Dai) ； 張丹蓉(Dan-Rong Chang) ； 羅美芳(Meei-Fang Lou)

《慈濟醫學雜誌》 10卷1期 (1998/03) Pp. 61-68

https://doi.org/10.6440/TZUCMJ.199803.0061

摘要

本文簡介台灣出院準備服務的推動狀況，並針對四家衛生署第一梯次補助試辦出院準備服的醫院，所是出的前面三年成果報告進行分析。結果顯示四所醫院均設置出院準備服務組和出院準備務員，但缺乏對組運作方式的評價，服務對象均是選擇高危險群的慢性病患。推行出準備服務的具體成括:後續照護資源的開發，病人的滿意度升高。然而出院準備對縮短病八匉均住院日的成效方面，各家醫院所得結果並不一致。其他的重要指標，如:病人出院後需求滿足程度、病人或家屬出後自我照顧的知識與技能，並未被列入評。由於試辦單位較偏重實際的業務執行，較缺乏需有更嚴謹且全面性的評價研究。(慈濟醫學1998;10:61-68)

關鍵字

出院準備服務 ； 繼續性照顧

並列摘要

In 1993, a policy to promote the implementation of discharge planning in Taiwan was announced by the Department of Health; Executive Yuan. Four hospitals have received grants from the Department of Health since 1994 in order to develop demonstration projects of discharge planning over three years. A secondary anlaysis on annual reports of the demonstration projects was conducted. The perspectives of structure and outcome of these demonstration projects were looked at. In terms of the structure of the hospital, all four projects established their multidisciplinary teams to provide the service of discharge planning. Hight risk patients were screened by the discharge planner and 1913 chronic patients received formal discharge planning in thes four projects. To measure the outcome of discharge planning, one or mort of the following variables; average length of stay (ALOS), rate of readmission and level of patient satisfaction, were selected as indicators, However, not all three variables wre included in each project. Every hospital showed a decline of ALOS at the initial stage of the project. However, a small increase of ALOS occurred in two hospitals after the National Health Insurance Program was implemented. The rate of readmission was decreased in one project and remained unchanged in the other projects. The level of pastient satisfaction to dischasrge planning was measured in only project and revealed an increase in patient satisfaction levels. The data of annual reports of demonstration projects have shown some beneficial effects of discharge planning on patient care. However, little data on reliability and valiaity were reported. Amore rigorous and well-designed evaluation study is required to reconfirm the findings.(Tzu Chi Med J1998;10:61-68)

並列關鍵字

discharge planningl ； continuity of care