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摘要


根據國家發展委員會之統計,國內人口高齡化之挑戰來的快速且嚴峻。其中,失能者之醫療及照護需求增加為醫療費用支出上升之重要原因。老年人的失能常導因於多重共病,但失能及伴隨而來的照護問題卻對多重共病的治療目標及治療方式影響甚鉅。國內目前之急性醫療及長期照護為雙軌制,彼此間缺乏整合不僅影響病患照護品質亦使得醫療支出及照護負擔更為沉重。此外,未來外籍看護人力因應東南亞國家政策逐漸緊縮,勢必亦對長期照護造成衝擊。為達成提升失能長者照護品質及「在地安老」之目標,統整現有資源打造兼具效率、品質、可近性之社區性長期照護及醫療整合方案實為當務之急。目前衛生福利部於推動中之長照2.0 政策有意參考美國已推動30 多年之高齡者整合照護計畫(program of all-inclusive care for the elderly, PACE),以下將就其源起、服務對象、運作方式、實證顯示之效益做簡要說明。

參考文獻


Landi F, Liperoti R, Russo A, et al. Disability, more than multimorbidity, was predictive of mortality among older persons aged 80 years and older. J Clin Epidemiol 2010;63:752-9."
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Eng C, Pedulla J, Eleazer GP, et al. Program of All-inclusive Care for the Elderly (PACE): An innovative model of integrated geriatric care and financing. J Am Geriatr Soc 1997;45:223-32."
Segelman M, Szydlowski J, Kinosian B, et al. Hospitalizations in the Program of All-Inclusive Care for the Elderly. J Am Geriatr Soc 2014;62:320-4."

被引用紀錄


鄧桂芬、李玉春、楊哲銘、黃國哲(2019)。作者回覆:奉養父母的末代,子女棄養的首代台灣公共衛生雜誌38(5),538-538。https://doi.org/10.6288/TJPH.201910_38(5).10808102

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