運用個案管理模式於充血性心臟衰竭住院病患照護之成效

The Effectiveness of Case Management Model on Inpatients with Congestive Heart Failure

本研究目的旨在探討運用個案管理模式於充血性心臟衰竭病患照護之成效，採隨機分派臨床試驗，對照組35位採病房常規照護模式，個管組36位採個案管理照護模式，比較兩組疾病認知程度、自我照顧行為、生活品質、平均住院天數、平均住院醫療費用及90 天再入院率之差異。結果顯示個管組疾病認知程度、自我照顧行為及生活品質高於對照組（p < .05）；平均住院天數比對照組少2.8天 （p < .05）、平均住院醫療費用少16,017.88元 （p > .05）、90天再入院率則少20.7% （p < .05）。其結果可供醫療機構對充血性心臟衰竭病患持續性品質改善，使能獲得更完善的照護。

The purpose of this study was to investigate the effectiveness of case management model on the care for patients with CHF. A randomized clinical trial was applied in this study. Subjects in the control group (n=35) received usual care, whereas subjects in the intervention group (n=36) joined the case management program. Differences in disease awareness, selfcare behaviors, quality of life, average length of hospitalization, average hospitalization costs, and 90-day readmission rates between 2 groups were analyzed. The results showed that the scores in disease awanress, self-care behaviors and quality of life were significantly higher in the intervention group (p < .05). Average length of hospitalization was less than that was in the control group by 2.8 days (p < .05). Average hospitalization cost was NT$16,017.88 less in the intervention group (p > .05). Finally, 90-day readmissions rate was reduced up to 20.7% in the intervention group (p < .05). The results of the study provided a way of continuous quality improvement for patients with CHF to the health care system.