出院準備服務與長期照護資源使用之相關性

目的：經由出院準備服務了解病人在出院後使用各項長照服務的相關影響因素，並分析接受與不接受轉介進一步長照服務的各項原因。方法：本研究採病歷回溯方式、橫斷式設計，研究對象為2017年度859位在區域醫院接受出院準備服務的病人，收集病人相關資料，及出院後安置情形。統計方法使用SPSS 21.0 for Windows統計軟體進行分析，包含描述性統計、卡方檢定進行推論性分析。分別檢定其基本屬性、影響服務利用之三個因素、出備篩檢結果及不同量表得分，對使用長期照護資源之影響。結果：在859位個案中，接受轉介長照服務者為58.91%，未接受轉介長照服務者為41.09%。年齡、婚姻狀態、子女數、教育程度、居住型態、特殊身分、有無經濟困難、有無照顧者、一年內有無住院紀錄、身體功能狀態、住院天數及出院準備服務篩檢評估等，均會影響長照服務使用比例。特殊身分（p＜0.01）、是否有經濟困難（p＜0.05）及是否有其他人能協助照顧（p＜0.01）。其中，接受出備服務之750位病人（佔87.3%）出院返家後有人可協助照顧，在使用長照資源服務的比例較低，使用比例只佔39.6%，未使用長照資源的比例約為42.9%。經濟上沒有困難的病人，超過50%並未使用任何長期照護資源，而且轉介至機構安置的比例也較低。結論：由本研究結果發現，經由出院準備服務介入與病人出院後長期照護資源使用是有相關性的。未來出院準備服務團隊在提供轉介長照服務時，宜加強了解照顧者在病人出院後之居家照護能力，並且依據病人照護上的需求提供多元的資源轉介及服務項目的選擇，以確保病人能得到持續性、計畫性的照護。

關鍵字

出院準備；長期照護；轉介服務

並列摘要

Objectives: To understand factors influencing the use of long-term care services after discharge through the discharge planning services and analyze reasons of accepting the referral for further long-term care services or not. Methods: This study adopted a retrospective, cross-sectional study. A total of 859 patients receiving discharge planning service in a regional hospital in 2017 were recruited. The patient information and settlement situations after discharge were collected. Statistical analyses were performed with SPSS 21.0 Windows. Descriptive statistics and chi-square tests were used to examine the effects of basic patient characteristics, three factors affecting the use of service, screening tests for discharge planning, and scores of different scales on the use of long-term care. Results: Among the 859 patients, 59.81% accepted referral service and 41.09% did not. Age, marital status, number of children, education level, living patterns, disability, income status, having caregivers, number of admissions within a year, physical function, duration of hospital stays, and assessment of discharge services all affect the utilization of long-term care. Seven hundred and fifty patients (87.3%) receiving discharge planning service were cared by their family members after going home, among whom 39.6% used long-term care resources, and 42.9% did not. More than 50% of those not having a financial problem did not use the long-term care resources. Furthermore, their transference rate to other facilities was also lower. Conclusions: Long-term care services are associated with the use of long-term care resources. The discharge planning service team should focus on understanding the homecare ability of the caregivers after patient discharge and providing various referral resources and service options to ensure sustainable and planned care.

並列關鍵字

discharge planning services ； long-term care ； referral

國際替代計量

出院準備服務與長期照護資源使用之相關性

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