台南區域癌症患者居家護理使用概況

Home Health Care Services Used by Cancer Patients in the Tainan Area

葉莉莉(Li-Ly Yeh) ； 謝淑惠(Shwn-Heuy Shieh)

《慈濟醫學雜誌》 10卷3期 (1998/09) Pp. 231-239

https://doi.org/10.6440/TZUCMJ.199809.0231

摘要

本研究目的為瞭解健保實施前台南區域癌症居家護理病患之人口學特質、轉介與回應概況及居家護理服務使用情形。以台南縣、市五家醫院附設居家護理部門78至84年健保實施前個案管理資料進行回溯性調查，並以SAS軟體進行統計分析。結果顯示174案平均年齡62.3歲，男性(58.6%)多於女性，診斷以氣管及肺之惡性腫瘤最多(15.5%)，91.4%為自費患者。個案居住分佈65.5%集中於近台南市之台南次區域，顯示城鄉居家護理資源不均。個案來源主要為五家機構內各單位癌症病患(70.2%)。由轉介時間確認住院個案轉介流程偏慢，63.0%之個案其轉介日與出院日差距在1日內，且35.2%之轉介單於出院後才收到，顯示出院準備服務待加強。護理服務項目以疼痛控常與營養支持所提供之注射所佔比例最大，個案管理中以死亡消案最多86.8%，每案平均管理日數為58.2日，平均家訪次數為7.2次，平均8.1日接受家訪一次。本研究結果可做為癌症病患出院準備服務及健保相關規範改善之參考，並做為醫療網整合台南區域長期照護資源之參考。

關鍵字

癌症 ； 居家護理 ； 使用型態

並列摘要

The purpose of this retrospective study is to examine the home health care services used by cancer patients in the Tainan area from 1989 to 1995; before the National Health Insurance program was introduced. Data were gathered from 5 home care agencies and analyzed by a computer system with SAS software. The study examined demographic and services data, including the total number of home visits, length of care , reasons for termination, frequency of serices, and nursing services provided. There was a total of 174 patients with an average age of 62.3 years old. The most common illness was trachea and lung cancer (15.5%), of the 174 patients, 91.4% had no insurance coverage. Most of the patients (65.5%) lived near the city of Tainan. The percentage of patients referred to the various agencies from inside hospital was 70.2%. Regarding to the in-patient referrals, 63.0% were done almost in the same day of discharge. Most of the services provided were injections, refer to cancer patients’ need of pain control and nutritional support. The average length of care was 58.2 day and the total number of home visits was around 7.2 times for each patient. The data indicated death of the patients was the leading reason for termination the services. The results of this study will be helpful in clinical practice, health care policy refinement and designing future research projects.

並列關鍵字

cancer ； home health care service ； utilization pattern