某獨立型居家護理所導入長期呼吸器依賴患者整合性照護計畫之服務現況分析

The Service Status of Implement IDS System from Long Term Ventilator Depended Patients in an Independent Nurse Home Facility.

楊式興(Shih-Hsing Yang) ； 朱秋蓉(Chiu-Jung Chu) ； 陸嘉真(Chia-Chen Lu) ； 簡辰霖(Chen-Lin Chien) ； 林昭成(Jau-Chen Lin) ； 卓貴美(Guei-Mei Jow) ； 龍芳(Fang Lung)

《呼吸治療》 12卷1期 (2013/01) Pp. 1-14

https://doi.org/10.6269/JRT.2013.12.1.01

摘要

Background and purpose: Independent nursing home facility implement the BNHI of payment project in the integrated delivery system (IDS) of long-term mechanical ventilator dependent (LTMVD) patients, then together with the addendum to the respiratory therapists and the chest physicians provide home care of LTMVD patients in home. However, in this care model of IDS, it is very important that if investigating received case characteristics then can improve their business effectiveness; therefore, our purpose is to investigate the characteristics of current received case by survey home place of residence and property of upstream referral hospital. Method: Experimental design is the retrospective study of purposive sampling, therefore, we investigate one independent nursing home facility after establishment in Taipei city then implement project of IDS to provide a home care service in receiving LTMVD patients. We collected medical records in retrospection from September 1, 2006 to December 31, 2009, collected data on patient age, residence, diagnosis, ventilator information, and the number of days in received the case, respectively, and to analysis the relationship between patient data and their residence and property of upstream referral hospital, respectively. And SPSS 19.0 of statistical software was used to data analysis. Results: Found enrolled case in home ventilator care during the study period, a total of 294, 154 males and 140 females; average age of 63.9 ± 24.2 years old (＜1~94); this facility was established in Taipei city, the maximum number of case was 134 of Taipei city. A maximum of case number was 190 form the medical center in upstream referral hospitals,80 regional hospitals, district hospitals of respiratory care ward of 24; invasive ventilator of 133, non- invasive ventilator of 161, however, have been closed service for 179. Still enroll service of 115. Average the receiving days of 450.8 ± 401.4 (2~1199).In the case number was Taipei, new Taipei of Medical Center referral cases (34.4%、26.9%) showed a statistically significant more than other counties and cities of 3.4% (P ＜0.001). The average age in Taipei, Taipei and other cities/counties were 65.3 ± 24.4, 59 ± 27.7, 68.7 ± 15.2 years old, New Taipei City was significant the youngest cases (P=0.032). The average number of enrolled days were 467 ± 413.4, 496.6 ± 411.6, 340.9 ± 339.2 days, and other cities/counties showed significant the shortest than Taipei City, New Taipei City (P=0.047). Conclusion: Independent nursing home care facility implement IDS project to provide home care of LTMVD patients, we sampled one facility in Taipei city, we found it is significant in the youngest is the new Taipei city, in the most of patient source is medical central and other cities is shorter in receiving case days. In addition, the home care of LTMVD patients in this model, the quality of care is the next more worth to do further study.

關鍵字

居家照護 ； 呼吸器依賴 ； 呼吸照護

並列摘要

Background and purpose: Independent nursing home facility implement the BNHI of payment project in the integrated delivery system (IDS) of long-term mechanical ventilator dependent (LTMVD) patients, then together with the addendum to the respiratory therapists and the chest physicians provide home care of LTMVD patients in home. However, in this care model of IDS, it is very important that if investigating received case characteristics then can improve their business effectiveness; therefore, our purpose is to investigate the characteristics of current received case by survey home place of residence and property of upstream referral hospital. Method: Experimental design is the retrospective study of purposive sampling, therefore, we investigate one independent nursing home facility after establishment in Taipei city then implement project of IDS to provide a home care service in receiving LTMVD patients. We collected medical records in retrospection from September 1, 2006 to December 31, 2009, collected data on patient age, residence, diagnosis, ventilator information, and the number of days in received the case, respectively, and to analysis the relationship between patient data and their residence and property of upstream referral hospital, respectively. And SPSS 19.0 of statistical software was used to data analysis. Results: Found enrolled case in home ventilator care during the study period, a total of 294, 154 males and 140 females; average age of 63.9 ± 24.2 years old (＜1~94); this facility was established in Taipei city, the maximum number of case was 134 of Taipei city. A maximum of case number was 190 form the medical center in upstream referral hospitals,80 regional hospitals, district hospitals of respiratory care ward of 24; invasive ventilator of 133, non- invasive ventilator of 161, however, have been closed service for 179. Still enroll service of 115. Average the receiving days of 450.8 ± 401.4 (2~1199).In the case number was Taipei, new Taipei of Medical Center referral cases (34.4%、26.9%) showed a statistically significant more than other counties and cities of 3.4% (P ＜0.001). The average age in Taipei, Taipei and other cities/counties were 65.3 ± 24.4, 59 ± 27.7, 68.7 ± 15.2 years old, New Taipei City was significant the youngest cases (P=0.032). The average number of enrolled days were 467 ± 413.4, 496.6 ± 411.6, 340.9 ± 339.2 days, and other cities/counties showed significant the shortest than Taipei City, New Taipei City (P=0.047). Conclusion: Independent nursing home care facility implement IDS project to provide home care of LTMVD patients, we sampled one facility in Taipei city, we found it is significant in the youngest is the new Taipei city, in the most of patient source is medical central and other cities is shorter in receiving case days. In addition, the home care of LTMVD patients in this model, the quality of care is the next more worth to do further study.

並列關鍵字

Home care ； ventilator dependent ； respiratory care