以網路資料庫提升人工關節置換病人照護品質

Using a Web-based Database to Improve Quality in the Management of Joint Replacement

陳清安(Cheng-Aun Tan) ； 洪聖惠(Sheng-Hui Hung) ； 黃淑雅(Shu-Ya Huang) ； 朱富平(Fu-Ping Chu) ； 王拔群(Pa-Chun Wang)

《醫務管理期刊》 12卷2期 (2011/06) Pp. 88-97

https://doi.org/10.6174/JHM2011.12(2).88

摘要

目的：衛生署統計每年全國約有三萬個膝關節及二萬五千個髖關節被置換。全世界骨科專家一致認為，人工關節置換術至少需十年的追蹤，才能判定手術成功與否；然而，目前在國內外尚缺乏此類相關追蹤報告，本研究將建置一套人工關節置換個案管理資料庫，提供個案術前、中及術後返家之全程追蹤管理，以提升醫療照護品質。方法：人工關節置換病人照護資料庫為DB2 V8，採servlet-JSP架構開發，記載病人基本資料、相關疾病、家族史、實驗室檢驗值、手術前、中、後之評估記錄、關節活動度變化及返家後續追蹤資料。結果：本資料庫於2009年建置完成，收案298名，使用者反應良好，醫療人員能有效追蹤個案並自動化收集監測相關照護品質指標，達到資訊即時、完整記錄及共享目的。結論：慢性病個案管理為未來醫療產業潮流，仰賴長期追蹤服務，唯有利用資料庫管理，整合病人手術全期及返家資料，才能提供以病人為中心完整持續性照顧。

關鍵字

人工關節置換術 ； 照護品質 ； 網路資料庫

並列摘要

Objectives: Statistics from the Department of Health, Taiwan show that approximately 30,000 knee joint replacements and 25,000 hip joint replacements are performed annually. Orthopedists around the world suggest that after arthroplasty, patients should be followed for at least ten years; however, a longitudinal study of this kind does not currently exist. Therefore, in order to facilitate patients' pre-, peri- and post-operative and long-term monitoring, we established a disease management database for joint replacement patients. The goal was to improve medical services and quality of care for patients. Methods: The database was developed on an IBM WebSphere platform, using DB2, Java, JSP, Java Script and used to collect patient information, including general data, co-morbid conditions, family history, laboratory reports, peri-operative assessments, joint range of motion, and home care outcomes. Results: The database was built in 2009 and 298 patients were initially recruited. User feedback was positive. Health care providers can now effectively follow and manage their patients. At the same time, quality care indicators are generated automatically, and this allows medical executives to periodically monitor performance. With this database, real-time information and complete records are available and can be shared. Conclusions: The management of chronic diseases is an emerging trend in medical service and this requires long-term follow-up. Only by establishing such a complete database can we provide true patientcentered medical care.

並列關鍵字

Joint Replacement ； Quality of Care ； Web-based Database

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