- 期刊
Factors Affecting the Effectiveness of Discharge Planning Implementation: A Case-Control Cohort Study
摘要
Background: In many hospitals, a discharge planning team works with the medical team to provide case management to ensure high-quality patient care and improve continuity of care from the hospital to the community. However, a large-scale database analysis of the effectiveness of overall discharge planning efforts is lacking. Purpose: This study was designed to investigate the clinical factors that impact the efficacy of discharge planning in terms of hospital length of stay, readmission rate, and survival status. Methods: A retrospective study was conducted based on patient medical records and the discharge plans applied to patients hospitalized in a regional medical center between 2017 and 2018. The medical information system database and the care service management information system maintained by the Ministry of Health and Welfare were used to collect data and explore patients' medical care and follow-up status. Results: Clinical factors such as activities of daily living ≤ 60, having indwelling catheters, having poor control of chronic diseases, and insufficient caregiver capacity were found to be associated with longer hospitalization stays. In addition, men and those with indwelling catheters were found to have a higher risk of readmission within 30 days of discharge. Moreover, significantly higher mortality was found after discharge in men, those ≥ 75 years old, those with activities of daily living ≤ 60, those with indwelling catheters, those with pressure ulcers or unclean wounds, those with financial problems, those with caregivers with insufficient capacity, and those readmitted 14-30 days after discharge. Conclusions: The findings of this study indicate that implementing case management for discharge planning does not substantially reduce the length of hospital stay nor does it affect patients' readmission status or prognosis after discharge. However, age, underlying comorbidities, and specific disease factors decrease the efficacy of discharge planning. Therefore, active discharge planning interventions should be provided to ensure transitional care for high-risk patients.
參考文獻
延伸閱讀
- 李美樺、吳姿蓉、卓宜陵、孫郁菁（2020）。A Study on the Relevant Effect on Nurses' Acceptable Attitudes and Satisfaction of Using a Discharge Planning Information System。澄清醫護管理雜誌，16(1)，26-36。https://www.airitilibrary.com/Article/Detail?DocID=18136702-202001-202001030027-202001030027-26-36
- 葉依琳（2022）。The Effects of Advance Care Planning on Death Literacy and Family Decision Consensus〔博士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU202203594
- 施勝烽、劉恆忻、陳映儒、蕭婷、林翊瑄（2017）。Creating Elder-Friendly Environments in Hospitals and Communities: Research on Discharge Planning Service。福祉科技與服務管理學刊，5(3)，241-256。https://doi.org/10.6283/JOCSG.201711_5(3).241
- 陳儀倩、張瑋婷（2020）。Factors Influencing the use of home care Services by Patients who Received Discharge Planning。澄清醫護管理雜誌，16(1)，37-46。https://www.airitilibrary.com/Article/Detail?DocID=18136702-202001-202001030027-202001030027-37-46
- 卓于媛、鄭鈺郿、劉雪玲、黃露萩、陳美如、朱怡蓁（2023）。Examining Effectiveness of Integration Program for Transition from Discharge Preparation to Home-based Medical Care。台灣家庭醫學雜誌，33(1)，36-43。https://doi.org/10.53106/168232812023033301004