腦中風病患轉介急性後期照護後整體功能狀態之成效探討

The Effects of the Modified Rankin Scale after Stroke Patients Involved in Post Acute Care

林淑惠(Shu-Hui Lin)

指導教授 ： 鄭雅愛 ； 高月慈

義守大學/醫學院/醫務管理學系/碩士(2016年)

摘要

本研究乃針對急性腦中風醫療狀況穩定之個案，轉介急性後期照護醫院，藉以瞭解個案轉介急性後期照護後的整體功能效益。採用次級資料分析法，利用健保資訊服務系統(VPN)和個案醫院中風登錄的資訊系統，收集2014年3月至2015年11月期間急性腦中風30天內轉介急性後期照護醫院與回家照護的病患，共有135位案例。運用統計軟體SPSS18.0版進行卡方檢定和獨立樣本t檢定來分析比較復原情況。研究結果顯示，轉介急性後期照護醫院的75人整體功能狀態前後改善平均分數 1.35分，相較於無轉介回家照護的60人前後改善平均分數為 0.65，統計結果有顯著性差異(P=0.001)，表示腦中風病患轉介急性後期照護後，整體功能狀態有顯著進步。衛福部推動轉介急性後期照護醫院，希望腦中風病人由醫學中心或區域醫院醫療穩定後出院，把握關鍵的3個月黃金恢復期，選擇離家近之急性後期照護醫院，經由醫療團隊的整合性介入和積極復健治療，將資源做最有效率的整合運用，進而增加個案整體照護品質，提升病人的整體功能狀態，減少失能儘早獨立生活返回社區。

關鍵字

腦中風 ； 急性後期照護 ； 整體功能狀態

並列摘要

The aim of this study is to assess the Modified Rankin Scale in clinical stable patients after stroke who undergo post-acute care. We analyzed data on 135 patients with acute stroke within 30days receiving post-acute care enrolled in health care information services system (Virtual Private Network ) and hospital stroke registry in VGHKS system between March 2014 to November 2015. Using statistical software SPSS 18.0 version of chi-square test and independent samples t-test to analyze comparative recovery situations. Among the 135 participants, 75 stroke patients involved in the post-acute care and 60 stroke patients went home care after discharge. Research result showed that the improved scores of Modified Rankin Scale was 1.35 and 0.65 between post-acute care and home care, respectively (P=0.001). The advancement of Modified Rankin Scale was significant in post-acute stroke care. The results indicate that there can be substantial benefit for stroke patient in post-acute care service model, which is both statistically significant and clinically important. We recommend for future development of post-acute care model in addition to the existing health care system and take advantage of long-term care system resources via all kinds of professionals’ teamwork. Therefore, the Ministry of Health, Welfare to promote post-acute care referral hospital, hope after stroke patients from the medical center or regional hospital medical discharge stability, hold the key to the three-month gold recovery, select the post-acute care hospitals close to home , the medical team involved in the integration and active rehabilitation treatment through the integration of resources to do the most efficient use, thereby increasing the overall quality of care cases, enhance the overall functional status of the patient, reduce disability as soon as possible return to independent living communities.

並列關鍵字

Stroke ； Post Acute Care ； Modified Rankin Scale

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