Different Health Conditions and Care Requirements of Home Health Care Patients Based on Income Status

不同經濟狀況的居家醫療整合照護病人健康狀況與醫療需求比較

蔡亮如(Liang-Ju Tsai) ； 郭冠良(Kuan-Liang Kuo) ； 吳岱穎(Tai-Yin Wu) ； 黃勝堅(Sheng-Jean Huang) ； 翁林仲(Lin-Chung Woung) ； 蕭勝煌(Sheng-Huang Hsiao)

《台灣老年醫學暨老年學會雜誌》 14卷4期 (2019/11) Pp. 203-217

https://doi.org/10.29461/TGGa.201911_14(4).0002

摘要

Objectives: The study aims at examining whether income status is associated with the health conditions and care requirements of home health care participants in Taiwan. Methods: A cross-sectional study was performed on the participants of the integrated home health care program in Taipei City Hospital, Renai Branch. Participants were divided into disadvantaged and non-disadvantaged groups based on their income status. Caregivers, living status, medical diagnoses, handicapped status, activity of daily living (ADL), caring plans, and major diseases were compared. Results: Of the 266 participants. 15 (5.64%) were financially disadvantaged. For participants living alone, more are financially disadvantaged than non-disadvantaged (p＜0.001). Both extent of disability (p=0.036) and major diseases (p=0.004) were significantly different. Non-disadvantaged participants had worse consciousness level (p=0.01), worse comprehension ability (p=0.006) and worse activities of daily living (p＜0.001). Non-disadvantaged group depended more on nasogastric tube feeding (p=0.013), had a higher rate of urinary incontinence (p＜0.001), and were in greater need of advanced home health care (p=0.001). Conclusions: Income status was associated with the health conditions and care requirements in home health care patients in Taiwan. Home health care needs may vary according to participants' income status. Provision of home health care service should be integrated with other social welfare policy to enhance comprehensiveness and continuity of care.

關鍵字

home health care ； financially disadvantaged ； welfare policy ； Taiwan

並列摘要

目的：分析居家醫療被照護者經濟狀況與健康及醫療需求的相關性。方法：某區域醫院居家醫療被照護者的橫斷性研究。具有低收入或中低收入戶身分的被照護者為經濟弱勢組，其餘為非經濟弱勢組。比較兩組的照顧者、居住狀況、疾病診斷、殘障狀態、生活自理能力、照護需求以及重大疾病。結果：266位被照護者中15位為經濟弱勢。失能程度與主要疾病兩組顯著不同。非經濟弱勢者獨居者較少，意識狀態較差，理解能力較差，生活自理能力較差。非經濟弱勢者較多鼻胃管進食，尿失禁，需要進階居家照護。結論：經濟狀況與居家醫療被照護者的健康及醫療需求相關。

並列關鍵字

居家醫療 ； 經濟弱勢 ； 社會福利 ； 台灣