某醫學中心出院準備服務執行情形之分析

Analysis of the Execution of Discharge Planning Service in a Medical Center

本研究之目的在瞭解南部某醫學中心出院準備服務個案之屬性、科系收案率、疾病診斷和主要照顧者類別率以及出院準備服務成果指標相關變項情形。研究結果顯示：自民國93年10月1日至94年9月30日止，出院準備服務收案的總個案數共3,247人，計3,882人次，佔全院總出院率之8.09%；個案性別以男性57.53%居多；平均年齡為57.98歲；收案科系以內科系66.25%居多；疾病診斷以腫瘤29.75%為首；主要照顧者以子女居多，佔31.13%；初次篩選收案率77.61%；平均住院日計26.77天；院內照會資源運用率為22.75%，其中50.06%為社會服務室照會；動向別以出院返家63.16%居多；逾期出院率19.68%，其中87.3%為疾病因素；14天內非計劃性再住院率計6.29%。研究結果可提供該醫學中心出院準備服務的評價基礎及該院長期照護政策方針的參考。且由於其14天內非計劃性再住院率較其他醫學中心為高，顯示仍有待改善空間，因此建議以14天內非計劃性再住院之原因及其相關因素探討作為未來研究方向。

The purpose of the study is to analyze the data of the discharge planning service in a medical center in southern Taiwan and to understand the demographic attributes of the cases, the case rate in terms of departments, the diagnosis of diseases, the main care givers, and outcome indicators of the discharge planning. This retrospective description analysis is based on the data collected from October 1st, 2004 to September 30th, 2005. A total of 3247 people with 3882 times of admission were about 8.09% of all hospital discharge patients. The result shows that 57.53% of the cases are male; the average age is 57.98; 66.25% of the cases come from the internal medicine department; the most disease diagnosis is tumor with a rate of 29.75%; 31.13% of the main care givers in the hospital are the son or daughter of patients; case immediate screening rate is 77.61%; the average length of hospital stay is 26.77 days; the utility rate of consultation service is 22.75%, in which 50.06% consults the department of the community service; the rate of returning home after hospitalization is 63.16%; the rate of overdue stay is 19.68%, in which 87.3% attribute to disease factors; the rate of unplanned readmission within 14 days after discharge is 6.29%. The results of this research can be the appraisal basis of the development of the discharge planning service and the guidelines of the case management and nursing model in this medical center. According to the analysis, further study should be conducted to decrease the high rate of unplanned readmission within 14 days after discharge.