腫瘤個案管理成果評量

衛生署國民健康局新增設癌症診療品質認證基準，要求醫院編制專任腫瘤個案管理師，顯示出腫瘤個案管理已成為醫療照護的趨勢與政策推動的重點。個案管理的成果評量重點包括個案管理者須有效的執行評估者、計畫者、促進者、代言者四項主要功能，而此四項主要功能的成效對個案有正向的影響。個案管理的成果評量是依據Donabedian所提出的由結構、過程及結果三個層面來著手。許多文獻均顯示個案管理的成果評量可包括：個案管理團隊、個管師合作度、自主性、決策參與度、臨床技能、健康照護過程、代言、資訊分享、協調、出院準備過程、住院天數、再住院、治療遵從、病人滿意度、員工滿意度、病人生理及功能、情緒狀態、心理社會結果、生活品質、個管時數、存活率等。測量成本效性則是評值護理個案管理模式的一個最重要的任務。成果評量未來對個案的管理是很重要的，在個案管理實務上需要成長及改進。目前國內腫瘤個管成果評量尚未一致，期待能盡快訂出標準，以利各醫院評估個管的成效！

關鍵字

腫瘤個案管理；成果評量；成本效性分析

並列摘要

The quality criteria and certification program of cancer care has been established recently by the Department of Health in the National Health Bureau. This program encourages hospital to establish the function of cancer case management and the role of dedicated case manager. The result-oriented quality assessment is focused on the positive impacts that the manager delivers, in carrying out his/her responsibility as an assessor, planner, facilitator, and spokesperson. This demonstrates that the cancer case management has become a trend in medical care and the focus of government policy. This article advocates the adoption of Donabedian's framework, to measure the quality and assess the benefits, of cancer care management program. This framework has 3 measurement aspects-structure, process, and outcome. The Structural components include collaboration, autonomy, Participation in decision making, etc. The Process components include care coordination process, client advocacy, discharge process, etc. The Outcome components include length of stay, readmission, patient satisfaction, quality of life, survival, etc. Donahebian's assessment framework enables meaningful analysis of cost-benefits in case management. The prospect of significant positive impacts encourages continuous improvement and maturity of the cancer case management program.

並列關鍵字

outcome measurement ； case management ； cost-effectiveness analysis

被引用紀錄

李娜蓉、陳秀蓮、李惠玲、洪雯玲、陳汝芬、吳聖良（2017）。婦癌病人介入個案管理照護於化學藥物治療完成率之成效。榮總護理，34(2)，167-178。https://doi.org/10.6142/VGHN.34.2.167

國際替代計量

腫瘤個案管理成果評量

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