已消案居家照護病人資料之初探

An Exploration of the Data in Discharged Patients of Home Healthcare Service

為瞭解居家照護已消案病人的長期照護資料，以經過效度、信度測試及預試的「居家照護已消案病人資料調查表」，針對台灣地區38所居家照護機構，83年1月至84年5月底接受居家照護已消案的病人收集資料，共收集427位個案，結果如下：接受居家照護服務的病人以老年人佔大多數（76.1％）。居家照護病人所需的照護項目以測量生命徵象、護理指導及一般身體檢查佔最多。病人消案時的活動能力、意識狀態，與收案時相比較，以維持不變者佔大部份。這些接受居家照護服務已消案的病人，其照護期間平均為215.08天，護士家訪次數平均為13.41次；平均16天訪視一次。不同疾病診斷分類在居家照護服務量與結果的各項資料上皆無顯著差異。病人所需的照護項目，則與居家照護服務量的各項資料及合併症項目呈現正相關。居家照護服務量與居家照護特殊結果的各項資料呈現正相關。上述研究結果，不但可反映居家護理業務的實況，尚可供健保局參酌，以做為未來修訂居家照護業務相關規定的依據。

In order to understand the data of receiving home healthcare service patients, a census of 38 home healthcare agencies was conducted in Taiwan. The target population consisted of all patients who were discharged from an home healthcare agency from January 1994 to May 1995. The results revealed: most of the receiving home healthcare service patients were the elders (76.1%). According to the percentage of the nursing care items, taking the vital signs, health teaching and physical examination were the top three. Comparison the health status of patients between admitted to and discharged from home healthcare agency, most of the patients were no change. Patients had been cared for an average of 215.08 days. Mean of home visits received by patients, 13.41 and 1.47 for nurses and doctors respectively. The nurse performed home visit once every 16 days. No statistically significant differences were found among the diagnosis, service utilization data and the patient outcomes. Items of nursing care were positively associated with service utilization data and one of the patient outcomes-complication. Items of the patient outcomes and service utilization data were highly correlated. This study is not only to show the actual profile of home healthcare service in Taiwan, but also to be a useful reference for National Health Insurance to revise the criteria of acceptance and payment for home healthcare service.