居家失能患者使用長期照顧十年計畫服務之現況

Utilization of the Ten-year, Long-term Care Program by Disabled Home-bound Patients in Taiwan

羅玉岱(Yu-Tai Lo) ； 林沛嫻(Pei-Hsieng Lin) ； 張春瑤(Chun-Tao Chang) ； 江怡慧(I-Hui Chiang)

《台灣家庭醫學雜誌》 21卷2期 (2011/06) Pp. 79-92

https://doi.org/10.7023/TJFM.201106.0024

摘要

Background and purpose: The ten-year, long-term care program of Taiwan was implemented in 2007; however, there is little information about the utilization of the program. The purpose of this study was to investigate utilization of the ten-year, long-term care program by disabled patients.Methods: This was a cross-sectional study. Participants were disabled patients who received home healthcare in southern Taiwan between September 2010 and December 2010. Home healthcare was provided by two skilled home care nurses who were based at a community hospital in the patients' vicinity. Data were collected using structured questionnaires. Caregiver data were also collected and analyzed.Results: Fifty-two valid questionnaires were obtained. The disabled patients had a mean (± SD) age of 73.8 ± 14.2 years, and the caregivers had a mean age of 46.7 ± 17 years. Among the 52 patients, 32(61.5%) had never used the ten-year, long-term care program prior to this study. The most frequently used service was the subsidy for or lease of assistive devices. This was followed by home care services and home nursing care with utilization rates of 17.3% and 11.5%, respectively. On bivariate analysis, the factors associated with long-term care service utilization were caregiver's age, caregiver's marital status, relationship between patient and caregiver, residential location, and the employment of a foreign caregiver (p ＜0.05). On multivariate logistic regression, only residential location was found to be associated with use of the ten-year long-term care program.Conclusions: We found an under-utilization of the ten-year, long-term care program by disabled, home-bound patients. Data indicated that the location of the patient's residence may have affected service utilization. To ensure reasonable utilization of long-term care services, government agencies should seek to promote accessibility to care. Current policy regarding the criteria used to establish patient eligibility for the program may need to be amended in order to improve service utilization. Research investigating the use of long-term care services by larger populations may also be warranted in order to diversify and improve service delivery in the future.(Taiwan J Fam Med 2011; 21: 79-92)

並列摘要

Background and purpose: The ten-year, long-term care program of Taiwan was implemented in 2007; however, there is little information about the utilization of the program. The purpose of this study was to investigate utilization of the ten-year, long-term care program by disabled patients.Methods: This was a cross-sectional study. Participants were disabled patients who received home healthcare in southern Taiwan between September 2010 and December 2010. Home healthcare was provided by two skilled home care nurses who were based at a community hospital in the patients' vicinity. Data were collected using structured questionnaires. Caregiver data were also collected and analyzed.Results: Fifty-two valid questionnaires were obtained. The disabled patients had a mean (± SD) age of 73.8 ± 14.2 years, and the caregivers had a mean age of 46.7 ± 17 years. Among the 52 patients, 32(61.5%) had never used the ten-year, long-term care program prior to this study. The most frequently used service was the subsidy for or lease of assistive devices. This was followed by home care services and home nursing care with utilization rates of 17.3% and 11.5%, respectively. On bivariate analysis, the factors associated with long-term care service utilization were caregiver's age, caregiver's marital status, relationship between patient and caregiver, residential location, and the employment of a foreign caregiver (p ＜0.05). On multivariate logistic regression, only residential location was found to be associated with use of the ten-year long-term care program.Conclusions: We found an under-utilization of the ten-year, long-term care program by disabled, home-bound patients. Data indicated that the location of the patient's residence may have affected service utilization. To ensure reasonable utilization of long-term care services, government agencies should seek to promote accessibility to care. Current policy regarding the criteria used to establish patient eligibility for the program may need to be amended in order to improve service utilization. Research investigating the use of long-term care services by larger populations may also be warranted in order to diversify and improve service delivery in the future.(Taiwan J Fam Med 2011; 21: 79-92)

並列關鍵字

disabled patients ； caregivers ； the ten-year long-term care program ； service utilization

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