急性醫療與慢性照護的橋樑－－亞急性與急性後期照護

Subacute and Post Acute Care: The Bridge between Acute and Long-Term Care

亞急性照護與急性後期照護是介於急性住院與長期照護間的照護方式，本文藉由文獻回顧，闡述美國亞急性照護、急性後期照護，與英國中間照護的背景、內容與效益，並探討其在我國之應用。若中央健康保險局將急性住院由論量計酬朝疾病診斷關係群（Diagnostic Related Groups, DRGs）支付制度改革，勢必會造成病患無急性照護需要時被要求出院，以縮減急性住院日；屆時國內亞急性或急性後期照護該如何配合發展，才能兼顧病患品質與費用節樽，值得藉由國外經驗來及早規劃與省思。

”Subacute care” and ”post acute care (PAC)” represent a level of care in between acute and longterm care. This review article introduces the background, related systems and cost-effectiveness of sub-acute and post acute care in the US and intermediate care in UK in order to identify issues and experiences from which Taiwan's policymakers and medical professionals can learn. If the Bureau of National Health Insurance moves ahead with plans to change medical payment policies for inpatients from the current fee for services system to Diagnostic Related Groups (DRGs) payment system, patients not meeting acute illness criteria will be asked to discharge in order to decrease the length of hospital stays. Therefore, prior to implement a prospective payment system, an appropriate subacute/post acute care system should be established and developed to ensure the quality of continuous care and total system cost savings.