城鄕社區老人使用居家護理服務情形及其預測因子之探討

Predictors of the Utilization of Home Health Care Services for the Urban/Rural Elderly

李怡娟(I-Chuan Li)

《護理研究》 5卷2期 (1997/04) Pp. 127-136

https://doi.org/10.7081/NR.199704.0127

摘要

本研究的目的旨在探討城鄉地區老人使用居家護理服務情形及其預測因了。採回溯性病曆查閱法：以台北市及宜半縣各一家醫院爲基礎的居家護理機構爲研究對象。收樣的標准如下：(l)病人年滿60歲以上，(2)曾受此二機構的居家護士訪視二次以上，(3)於民國七十六年至八十二年六月間已結案的個案。以Balinsky提出的「使用密度」及Kempen的「照顧指標」來測得居家護理使用的頻率及每次接受服務的強度。結果顯示病人年齡、婚姻狀況、宗教信仰、機構類型【都市（台北）／鄉村（宜蘭）】、機構與病家之間交通花費的時間、是否有保險給付服務費用、疾病診斷、日常生活活動能力、以及身骸殘障的天數等因素影響居家護理病人使用護理服務的數量及頻率。建議應發展以社區爲基礎的居家照護支持綱絡，同時利用衛生所的人力及設備等資源來發展居家護理，以期減短病家與居家服務機構之間的距離，速到服務利用可近性。同時建立居家護理病人分類制度，以便能有效控制服務費用，提升護理品質及作好個案管理。

關鍵字

城鄕老人 ； 居家護理 ； 服務使用情形 ； 預測因子

並列摘要

The purposes of this study were to understand the utilization behaviors of home health care (HHC) services and their correlates for urban/rural elderly. The amount of HHC utilization was calculated using Kempen’s index of care and Balinsky’s intensity of HHC usage. A retrospective record review was used in this study. Two convenient HHC agencies were selected in the study; one from an urban area and the other from a rural area. The criteria for inclusion were (1) patients who were at least 60 years old, (2) had been visited at least twice before being discharged, and (3) were discharged during 1987-1993.
Study results showed that age, marital status, religious preference, the type of agency, the travel time from the agency to their home, whether covered by insurance, medical diagnosis, ADL score, and disability days prior to receiving services were directly related to HHC utilization. Results suggest that there is a need to initiate community supportive services for HHC patients and to shorten the distance between the agency and patient’s home through providing additional HHC services in health stations in communities. At the same time, it is important to develop an HHC patient classification system in order to contain the cost of services and to improve the quality of care through the utilization of the case management system.

並列關鍵字

urban/rural elderly ； home health care services ； utilization ； predictors