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Rehabilitation Fees, Length of Stay and Efficiency for Hospitalized Stroke Patients: A Preliminary Study Based on Function-Related Groups

中風住院病人之復健治療費用、住院天數和效率-依功能相關群組分類的初步研究

摘要


本研究主要目的在探討中風住院病人失能嚴重程度與復健治療費、住院天數和效率之間的關係。本研究以高雄醫學大學附設中和醫院民國八十六年期間因初發性腦中風住院在復健病房接受復健治療之患者107位為對象。在剛住院復健科和出院時,分別使用功能獨立自主量表(Functional Independence Measure, FIM)來評估生活功能恢復狀況。依據失能障礙程度使用住院時FIM得分依功能相關群組分類,共分為28位(26.2%)重度(18~36分)、48位(44.8%)中度(37~72分)和31位(29.0%)輕度失能障礙(73~126分)三組。所有病人平均復健治療費用27,645±13,812元,平均住院天數34.7±16.7天,住院和出院時平均FIM得分56.8±24.2分和76.6±26.2分,平均復健效率指標0.7±0.7。統計分析顯示:三組不同失能障礙分別在復健治療費用和住院天數之間有明顯差異性;然而,復健效率並沒有明顯差異性。本研究結果發現使用住院時FIM得分依據功能相關群組分類可以區別中風住院病人復健治療費用和住院天數的需求,或許適宜規畫做為未來前瞻性病例給付中風病人復健治療費用的參考。

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並列摘要


The purpose of this study was to examine the relationships between severity of disability and factors such as rehabilitation fees, length of stay and efficiency for hospitalized stroke patients. One hundred and seven first-time stroke patients were studied consecutively for this study. They were recruited from a rehabilitation ward in a university medical center during 1997.Functional ability was evaluated using the Functional Independence Measure (FIMTM) instrument on admission and discharge. Stroke patients who presented with similar degrees of disability were Put together using the admission FIM score (FIM Function-Related Groups, FIM-FRGs) for further analysis. Twenty-eight (26.2%) patients examined were categorized as severely disabled (scored 18-36),48 (44.8%) moderately disabled (scored 37-72)and 31 (29.0%)mildly disabled(scored 73-126). The average expense on rehabilitation fees, for the average rehabilitation length of stay (LOSR) of 34.7±16.7 days, was NT$ 27,645±13,812. The FIM score improved from 56.8±24.2 on admission to 76.6±26.2 at discharge, with a rehabilitation efficiency index (EIR) of 0.7±0.7. Further analysis indicated that there were significant differences among the three disability groups on rehabilitation fees and LOSR while EIR was unaffected. The findings of this study suggest that FIMFRGs can differentiate different rehabilitation needs in terms of rehabilitation fees and LOSR; therefore, a prospective case payment system based on FIMFRGs is suggested for stroke rehabilitation reimbursement scheme in the future.

被引用紀錄


戴桂英(2007)。中風出院病人後續醫療照護之研究〔博士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2007.03380

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