長照資訊管理系統導入成效評估之個案研究

全球老年人口的逐漸增加與醫療水準的提升，各國對醫療照護的需求，已經開始由急性醫療為主的需求逐漸轉為銀髮健康及長期照護。台灣由於平均壽命延長及生育率持續降低等問題，亦面臨人口結構急速老化，而人口老化使得慢性疾病的醫療服務需求不斷增加亦提高了長期照護之需求；長期照護市場競爭已趨於白熱化，其競爭之態勢與醫療院所相仿，但是相較於醫療院所積極引進資訊管理系統提昇經營效率，增加競爭優勢的做法，長期照護機構在此方面的投入就顯得緩慢許多，特別是小型的長期照護機構，因為建置需投入的資金龐大，常令業者聞之怯步。長照機構由於住民醫護依賴程度，照顧人力及護病比有法規規定，現行的電腦套裝軟體已經逐漸無法滿足單位需求，目前醫療資訊設備市場上日新月異推出各種主動監測與大量數據的通訊與收集的智能設備，管理者迫切需要導入量身訂做的長期照護資訊管理系統，以協助其改善資訊品質與提升管理效益。本研究以個案研究法進行，分別選擇護理之家、老人養護中心、老人長期照護中心各一家為個案，藉由文獻蒐集、整理、分析與實地訪談的方式，並佐以次級資料，評估導入長照資訊管理系統的成效，結果發現導入長照資訊管理系統的淨效益超過個案預期，選擇有開放式架構、資通訊能力與服務可近性的系統廠商可以改善資訊管理作業與提升照護品質，除了管理者的理念與資金投入以外，政府政策的推動及主管單位評鑑的需求亦是機構導入長照資訊系統的關鍵因素，可作為其他長期照護機構建置導入長照資訊管理系統之參考。在長期照護產業的激烈競爭中，善用經營分析工具，為市場環境可能的劇烈變化提前準備，找到未來的方向，啟動企業的變革，與建立核心競爭力的優質團隊，才能面對未來瞬息萬變的長照產業市場。

關鍵字

長期照護；長照資訊管理系統；導入評估；個案研究

並列摘要

The aging population’s needs in medical and care services are increasing in recent decades. The disable older adults need long term care delivered by long term care facilities. Care is given by medical professionals, nurses and nursing care staffs. The purpose of long term care is to recover the physical function of older adults, as well as to improve their social abilities. Long-term care information systems (LTCIS) provide information when care delivers need when making decisions in their daily works. LTCIS can serve as a basis for sharing information among team members. Beside, LTCIS provides management information to long term care facilities for improving their management efficiency and increasing competition edge among the competitors. Long term care delivers need to form a team for caring these residents. LTCIS has many differences from information systems using in hospitals. Comparing with hospital information systems, LTCIS deals with residents who having longer length of stay, combing physical and mental problems to solve, and so on. Therefore, prior research in adoption of hospital information systems can not apply to LTCIS adoption. Why and how long term care facilities adopt LTCIS should be studied in depth. The findings of our study can be used as a model when long term care facilities making decision in adoption of LTCIS. The purpose of this study is to conduct a multiple case studies to discover why these case respondents making decision in adoption of LTCIS, how they deal with problems in the adoption process, and what advantages and disadvantages after LTCIS adoption. Three cases, one is a medium nursing home, another is a retirement center, the other is elder care and rehabilitation center, were interviewed. The questions of interview were conducted according to prior related research and the comments providing by experienced management professionals of long term care facilities. After interviews, findings were interpreted and suggestions were derived to form the results of this study. Suggestions are derived. First, vision has to be formed among entire management level staff before they decide to adopt LTCIS. Vision can guide the motivation of LTCIS adoption and can be referenced in the adoption plan to judge whether an action should be or should not be in the plan. Second, LTCIS adoption and implementation should follow the laws and regulations of related government’s agencies. Long care facilities, as medical institutions, are regulated by restrict laws and regulations. LTCIS should provide the needed information according to the laws. The procedures in LTCIS disobey the laws are also forbidden. Last but not least, the interviewee believed that LTCIS brought advantages of LTCIS, but also should notice the disadvantage brought by LTCIS in the adoption. Advantages and disadvantages are two-edged sword that should be traded off when top management level making decision of adopting LTCIS.

並列關鍵字

Long Term Care ； Long Term Care Information Systems (LTCIS) ； Adoption ； Case Study

參考文獻

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許哲瀚, & 唐憶淨. (2008)。遠距居家照護的現況與未來. 2008年。通

陳正芬 (2011)。我國長期照顧政策之規劃與發展：社區發展季刊。

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長照資訊管理系統導入成效評估之個案研究

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