人口高齡化造成失能者長期照顧需求增加,隨著台灣長期照顧體系的建構,逐漸擴增照顧的對象,所提供的照顧服務日趨多元,面對資源有限的情況下提供適時、適切的照顧服務,故照顧管理的整合機制扮演重要角色。過去十幾年照顧管理制度在長期照顧成效多聚焦於服務的使用量及滿意度的探討,然而對於實質照顧的影響卻少有具體的報告,故本文運用系統性文獻回顧探討照顧管理制度對長期照顧之成效,資料庫包括PudMed、EBSCO、ProQest、HyRead Journal、華藝線上圖書館及臺灣博碩士論文知識加值系統,進行資料庫研究文章的搜尋、檢索,共篩選出7篇研究。結果顯示儘管各國在長期照護體系的照顧管理方式有所差異,老年個案運用照顧管理制度對死亡率無影響,而個案自覺健康狀況較佳、身體活動與認知功能改善、減輕憂鬱、降低醫療費用或再住院率,以及減輕家庭照顧者的身體負荷。期望藉由本文初步發現能提供相關單位之參酌,強化長期照顧管理制度、落實社區整體照顧服務體系及提供更有效率的長照服務以提升照顧品質。
The aging population has leaded an increase in the demand for long-term care of the disabled elderly. With the establishment of long-term care system in Taiwan, the number of long-term care recipients has gradually expanding and the care services becoming more diversified. In order to provide care services appropriately and timely with the limited care resources, integrated care management mechanism plays an important role. In the last decades, the effectiveness of the long-term care management system had focused on the usage of services and satisfaction. However there are very few specific reports about the impact of substantive care. Therefore this article employs systematic literature review to explore the effectiveness of care management system on long-term care. The databases include PubMed, EBSCO, ProQest, HyRead Journal, Huayin Online Library and National Digital Library of Theses and Dissertation in Taiwan. A total of seven studies were retrieved and incorporated in this study. The results indicate that despite those differences in long-term care management methods in various countries, the usage of the care management system in elderly cases has no effect on the mortality rate; while the cases subjectively feel their health status got better, physical activity and cognitive function improve, depression mitigate, medical expenses or rehospitalization rate drop, and reduction on the physical burden of family caregivers. Based on the preliminary findings, we hope it may provide as a reference to implement integrated community long-term care service system, strengthen the long-term care management system, and supply more efficient care services to improve the quality of care in the future.