多元社區健康營造、連結長照永續深耕

Community Health Promotion with Multiple Services Links to Continuous Local Long-term Care System

洪大川(Ta-Chuan Hung) ； 魏菁瑤(Ching-Yao Wei) ； 黃初雪(Tsu-Hsueh Huang) ； 張文瀚(Wen-Han Chang) ； 葉宏一(Hung-I Yeh) ； 施壽全(Shou-Chuan Shih)

《健康促進研究與實務》 1卷1期 (2018/07) Pp. 9-19

https://doi.org/10.29442/HPRP.201807_1(1).0002

摘要

目的：社區健康促進推動是一個讓醫療服務得以走出藩籬進入群眾，並深耕社區民眾健康概念與行為的方法。馬偕紀念醫院有鑒於醫院除了被動的醫治疾病外，為落實在地民眾的健康，拓展醫療服務走入社區，以人為中心、社區為基礎，落實「健康生活化、生活健康化」目標。方法：本院以淡水地區健康營造為起點，現已延伸至三芝、八里、五股、蘆洲地區，並建構社區資源，連結多元組織、多元活動、多元服務之模式深入社區，實地的整合院內、外資源。將「社區發展小組」、「淡水馬偕紀念醫院社區健康促進推動委員會」、「健康服務站」建構為社區健康營造網絡平台模式，提升院方醫療服務的向外推展及契合社區民眾健康需求，得以落實政府衛生政策，增進民眾健康，此推動模式通過「國家品質標章」認證。結果：將社區組織機構資料庫依各活動需求媒合邀請參與，如於院內「馬偕健康日」嘉年華多元活動、多組織參與形式，於院外社區67個「健康服務站」提供量測、諮詢、宣導之單一窗口多元服務。充能近500位在地志工提供民眾身體質量指數（Body Mass Index，BMI）、血壓、腰圍等簡易生理量測或活動時人力支援。醫院端由六職類專業人員走入社區進行血糖、膽固醇檢測，營養、藥物、失智、體能等諮詢及轉介服務。至今一年舉辦約1,184場次活動、健康服務站約4,636人／83,574人次量測，2016年BMI、高血壓與腰圍異常值改善率分別為1.3%、5.1%及1.4%。結論：面對高齡社會浪潮的來臨，因應社會照護型態的變革，使得在地化照顧儼然已成趨勢。本院社區健康營造近年來陸續升級健康服務站照護品質，增加高齡者健康識能；失智專業諮詢及篩檢；招募及訓練失智志工；2個健康服務站輔導為C級巷弄長照站；7個健康服務站提供動健康延緩失能照護等，連結長照2.0之推展，提供小規模多功能服務，建構三段五級之照護體系，以連結長照永續深耕，創造政府、社區、醫院之三贏局面的社區健康營造。

關鍵字

社區健康營造 ； 組織網絡平台 ； 健康服務站 ； 健康促進推動志工 ； 長期照護

並列摘要

Objectives: Community health promotion is a way to get medical services out of the fence and prove the health concept and behavior of community. In addition to passive treatment, MacKay Memorial Hospital has expanded health care services into the community for public health, the main target is ＂Person -centered＂, ＂community-based＂, ＂healthy living, live healthy＂. Methods: Our hospital activates health promotion from Tamsui district, nowadays has been extended to Sanzhi, Bali, Wugu and Luzhou districts, to build a model of multi-organizations, multi-activities and multi-services in the community. Integrating community resources which are internal and external, the platform of network for community health promotion based on ＂Organization of Community Development Team＂,＂Organization of Community Health Promoting Committee＂ and ＂Health Stations＂ , improve the medical services forward and fit the needs of the community, was awarded Symbol of National Quality (SNQ).Results: We emphasis on the role of social interactions and involvement, such as, inviting different kinds of community organizations to participate the ＂Mackay Health Day＂ , establishing 67 health stations in communities to offer one-window multi-functions service. We recruit and empower near 500 local volunteers, at a fixed time and location, measuring Body Mass Index (BMI), Blood Pressure (BP), abdominal waist etc.. Six types of medical professionals go into the community for blood glucose, cholesterol testing, nutrition、Dementia、 physical and other counseling and referral services. Up to now, we have held about 1184 events, 4636 people / 83574 counts measured in health stations in one year. In 2016, BMI outliers improved 1.3%, hypertension outliers improved 5.1%, and abdominal waist outliers improved 1.4%. Conclusions: In the face of an aging population trend and the development of health care. ＂Aging in place＂ is the core concept of community health promotion. In our hospital, we upgrade the service of health stations one after another: enhancing the knowledge of local elderly; increasing dementia screening and professional advice service; recruiting and training dementia care volunteers; turning 2 health stations to become long-term care units in the alleys; 7 health stations begin to provide disabled care etc. Connecting the ＂Long-term Care Plan 2.0＂ , we provide a small-scale multi-functions service for community health promotion, and we construct of ＂five levels in three sections＂ care system to create a win-win-win situation for the government, community, and hospital.

並列關鍵字

Community Health Promotion ； Organizing Network Platform ； Health Stations ； Health Promoting Volunteers ； Long-term Care