物理治療介入健保系統長期使用呼吸器患者整合性照護之探討

Investigation of Physical Therapy Utilization in Integrated Delivery System among Patients with Long-Term Mechanical Ventilation

江玲玲(Ling-Ling Chiang) ； 陳喬男(Chiao-Nan Chen) ； 曹昭懿(Jau-Yih Tsauo) ； 吳英黛(Ying-Tai Wu)

《物理治療》 31卷1期 (2006/02) Pp. 39-45

摘要

目的：本研究探討在民國90年7-12月間，各層級醫院使用呼吸器者其物理治療介入的情況，並比較在地區醫院長期使用侵襲性呼吸器有無物理治療介入兩組患者的人口學基本資料和診斷分佈。方法：研究資料取自民國90年全民健康保險學術研究資料庫，先將使用呼吸器費用醫令碼者篩選出來，再依申報醫事機構、物理治療醫令碼來探討物理治療介入的情況，以敘述性統計、t檢定和Chi-square檢定呈現和分析資料。結果：研究期間各層級醫院共有4,001人使用呼吸器，以使用侵襲性呼吸器者最多，4,001人中同時申報物理治療者計153人(3.8%)。有24.9%（997人）使用超過21天。地區醫院長期使用侵襲性呼吸器者有無物理治療介入的兩組，無論在性別、年齡、疾病診斷分佈並無差異，最主要疾病的診斷分別為呼吸系統疾病和循環系統疾病。結論：長期使用呼吸器病患之物理治療使用率不高，建議物理治療人員應積極參與包括居家之整合性照護計畫，以協助提昇患者之生活功能、品質。

關鍵字

長期使用呼吸器患者 ； 物理治療 ； 全民健康保險學術研究資料庫

並列摘要

Background and Purposes: Integrated delivery system has been provided started since 2000 for ventilator patients. These patients were thus transferred to local hospitals or so called respiratory care ward after prolonged use of ventilator. Our study firstly aimed to report the utilization of physical therapy in patients with mechanical ventilation from July to December, 2001. Secondly, it made comparison in demographic data and diagnosis distribution between the patient groups with and without physical therapy who used invasive ventilator in local hospitals during this period. Methods: National health insurance database 2001 after systemic sampling was released from National Health Institute and used in this study. Descriptive statistics, t-test, and Chi-square test for group comparison were used for data analysis. Results: There were 4,001 patients on mechanical ventilator and 24.9% (n=997) among them who used the ventilator more than 21 days during the period of July through December, 2001. The utilization rate of physical therapy was 3.8% among all these patients. There were no differences in distribution of gender, age, or diagnosis between patient groups with or without physical therapy intervention in local hospitals with long-term invasive mechanical ventilation. The leading diagnosis was respiratory diseases, followed by circulatory diseases in both groups. Conclusion: We suggest to promote the utilization of physical therapy in patients with long-term mechanical ventilation. Physical therapists should actively involve in the team for caring these patients throughout the different phases of integrated delivery system in order to enhance their function and quality of life.

並列關鍵字

Patients with long-term mechanical ventilation ； Physical therapy ； National Health Insurance Research Database