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出院準備服務中物理治療之評估與轉介系統探討
The Development of Evaluation and Referral System of Physical Therapy in Discharge Planning
Abstracts
文為特別報導，是有關長期照護的出院準備計畫。持續性治療模式，通常由出院準備計畫開始作起，使患者在少量的成本花費內，接受適量的醫療照護。住院期間，部分專業人員不清楚長期照顧體系物理治療的評估重點，也不清楚持續性物理治療收案條件。台灣的出院準備轉介物理治療是於1999~2000由衛生署委託台北市物理治療師公會建立篩檢量表、收案條件與轉介流程。選台北市與市政府長期照護管理示範中心簽約的醫院為主進行研究調查。兩年共篩檢79位中風、73位骨折、54位關節置換、16位脊髓損傷及19位頭部外傷。採用自行設計之物理治療評估篩檢表與轉介流程，結果是轉介場所的收案條件與物評分數（肌力與平衡能力等）、巴氏量表分數高低為密切相關，與居住是否獨居、是否缺乏照顧者或是住樓層而無電梯的相關性較不高。所以出院準備小組的物理治療參與評估與篩檢，有助於持續性照顧的轉介。同時近年來物理治療師於出院準備服務中的角色與物理治療轉介的政策也加以說明。
Parallel abstracts
This is the special report of the discharge planning in long-term care (LTC) system. The continuing therapy usually starts from discharge planning in order to having good care with least cost. During hospitalization, some professional personnel are either not clear about the content of assessment, nor the inclusion criteria for physical therapy in long-term care. In 1999~2000, the Department of Health sponsored Taipei Society of Physical Therapy to develop the evaluation form, inclusion criteria and the referral system. The hospitals in Taipei city having the contract with the government LTC managing center were selected. Totally, 79 stroke patients, 73 subjects with fracture, 54 subjects with joint replacement, 16 subjects with spinal cord injury and 19 subjects with brain injury were assessed in discharge planning. The self-developed physical therapy evaluation form and the referral pathway were introduced. The study results indicated that the inclusion criteria for physical therapy in LTC is highly related to the score of physical therapy evaluation (including strength and balance etc) and the Barthel Index score, but not significantly related to living alone, lacking care-givers, or living up-stairs without elevator. Therefore, the physical therapy participation is helpful for the referral system in LTC continuing service. The recent policy and role of physical therapy in LTC system are also discussed.