醫院型家庭責任醫師制度個案健康狀況研究

目的: 在醫院型家庭責任醫師制度下，比較到宅訪視個案及非到宅訪視個案的健康狀況。方法：以社區醫院為基礎的醫院型家庭責任醫師制度，針對社區民眾以及至醫院長期就診的病患，進行收案。並且分成到宅訪視個案及非到宅個案進行醫療關懷。同時收集這些個案的基本資料、疾病史及進行量表評估。結果：自2015年4月至10月，北部某區域醫院共有3960人同意參與；其中有326人為到宅訪視個案。相較於非到宅訪視個案，到宅個案多屬於獨居、低收入、行動能力差、無生活自理能力，有較高血壓、失智症及心、腦血管疾病史，且有較高的憂鬱症比例。結論：到宅關懷的個案多屬於有失智症、心血管疾病史及憂鬱症的患者，後續研究應該針對此類患者探討到宅關懷的醫療效益優劣。

關鍵字

家庭責任醫師制度；全民健康保險法；醫院型家庭責任醫師制度；到宅訪視；健康狀況

並列摘要

Objective: To investigate the health conditions of cases cared under the Community Hospital-Based Family Physician System and those who were not. Method: community residents and patients who visited our hospital for regular medication treatments were enrolled under the Community Hospital-Based Family Physician System. They were divided into two groups-home visiting group and clinic visiting group. Personal data including general status, past medical history, and current diseases were collected; structure questionnaires evaluation were also conducted. Result: A total of 3960 people including 326 home visiting cases agreed to join the program between Apr. 2015 and Oct. 2015. Most of the home visiting cases were living alone and of low income, disability, and poor self-care ability. There was a higher percentage of hypertension, dementia, cardiovascular, cerebrovascular disease and depression in home visiting group compared with clinic visiting group. Conclusion: Subjects in home visiting group were with high percentage of dementia, cardiovascular disease and depression. Further research for costeffectiveness evaluation of home visiting group is warranted.

並列關鍵字

Family Physician System ； National Health Insurance Act ； Hospital-Based Family Physician System ； home visiting ； health conditions

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醫院型家庭責任醫師制度個案健康狀況研究

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