台南區域居家護理資源使用分析

The Utilization of Home Care Services in Tainan Area

葉莉莉(Lily Yeh) ； 溫敏杰(Miin-Jye Wen) ； 徐畢卿(Bih-Ching Shu)

《中華公共衛生雜誌》 17卷3期 (1998/06) Pp. 253-264

https://doi.org/10.6288/CJPH1998-17-03-13

摘要

我國於民國82年底，65歲以上老年人口已佔全人口的7.1%，正式邁入老年社會。在老年人口相對增加下，長期照護已成為台灣必然面對的問題。近年來居家護理的服務需求與成長日益增加，在全民健保將之納入給付後更廣受矚目。本研究根據台南縣市五家醫院附設居家護理部門，自民國78年至84年健保實施前之個案管理資料加以調查分析，藉以瞭解台南區域居家護理資源使用型態，以做為醫療網規劃居家護理資源，及健保相關規範修改之參考。
本研究根據571份個案管理資料作回溯性之分析，個案平約年齡67.7歲，以71~80歲佔最多數(35.9%)，以腦中風(43.0%)及自費者(86.0%)為居家護理資源使用最大族群；個案居住分佈65.3%集中於近台南市之台南次區域，顯示台南區域居家護理資源城鄉分佈極不均。護理服務項目以營養、傷口、泌尿道與氣切護理及各項技術服務為主，護理師專業性功能亦佔所有服務21.3%；消案原因以死亡(59.0%)最多。
個案管理日數及家討頻率因診斷別有顯著差異，顯示不同疾病照護需求不同，使用居家護理資源型態不同。建議健保對居家護理相關規範，應反應不同診斷個案特質。本研究結果可做為醫療網整合資源、設置居家護理地點參考，同時做為修正居家護理相關規範之參考。

關鍵字

居家護理 ； 資源使用

並列摘要

The purpose of this retrospective study was to examine the utilization of home care services in Tainan area from 1989 to 1995-before National Health Insurance program executed. The study examines demographic and utilization data, including total number of home visits, duration of usage, reasons for termination, frequency of services, and nursing service provided. The data were analyzed with a SAS computer system. There were a total of 571 subjects and their average age was 67.7 years old. The two leading diagnoses were CVA (43%) and cancer (30.5%). Eighty-six percentage of these subjects had no insurance coverage. 65.3% of the subjects lived near Tainan city, and only 8.7% of the subjects lived in rural areas. In 1994, only 15.1% of those who needed home health care in this area employed such services. The findings indicated that the consumption of home health care services varied with the diagnosis of the patient. In addition, the most common services provided were those related to urinary tract care, nutritional care, wound care, and trachea care, etc. The results of this study can be used as a reference in policy making to integrate and allocate home health care services in Tainan. Further, the utilizing pattern can be used to refine NHI regulations.

並列關鍵字

home health care services ； utilization