由於國人平均壽命不斷地延長,中老年慢性疾病取代急性傳染病,成為重要的健康問題。目前國內各級醫療機構的發展,多偏重於以急性病患為主要服務對象的綜合醫院,甚少有針對慢性病患的長期照顧設施,在急性醫療機構治療慢性病息,乃是一種醫療資源的浪費。有鑑於此,本研究探討患者的長期住院因素,諸如:息者住院不必自己支付醫療費用、出院後家人不會照顧、罹患慢性疾病、出院後無人可提供家庭照顧、有合併症發生、車禍糾紛、醫療糾紛、因難託人關說...等,並提出因應之道。由研究中得知患者年齡、家庭狀況、診斷、及提供照護之家中成員數,與醫療需要評估量表得分有關。患者性別、診斷、提供照顧之家中成員數,與照顧需要得分有關。研究中得知超期住院患者適合長期照護者,占當日總住院人數4.57%,亦即有4.57%患者不必要住在急性病床。為減少寶貴醫療資源的浪費,誠宜設法杜絕患者因生理診療需要以外之因素,而超期留住在急性病床。
Owing to the lengthening of the average life span in Taiwan, the chronic diseases for adults, not acute disease, have become the most serious problem to public health. In Taiwan, the development of acute general hospital made a remarkable progress, but the long-term care facilities have been unable to keep up with it. In view of making good use of medical resources, it's waste to treat a patient ill with chronic disease in acute medical mechanism. Consequently, this research is directed towards surveying the accessibility and necessity of practice long-term care. In this research, we will analyzed the way to select reasonable care setting and assessed patient and family at their acceptability of long-term care. We will research on the factors of prolonged hospitalization, such as: medical assurance, absence of care abiIity, chronic disease, lack of home care provider, complications, traffic accident legal problems, malpractice suits, …etc., and will provide the way to solve these problems. Just as what we have mention about in this research, we can come to the conclusion that medical need appraisal scores have relation to patient's age, family type, diagnosis and home care provider. And care need appraisal scores have relation to patient's sex, diagnosis and home care provider. In summary, 4.57% of prolonged hospitaIizations shouId be given long-term care. In other words, 4.57% of inpatients are not in need of acute medical care. To prevent from wasting any medical "resources, we should restrain those prolonged hospitalizations not for physical demand.