評值個案管理模式於大腸直腸癌照護之效益

Evaluating of Effectiveness on Case Management Model in Colorectal Cancer

本研究評值個案管理模式於大腸直腸癌病人之效益。研究採回溯性研究，統計自2006年1月至2009年12月，共計651位大腸直腸癌病人。實驗組共326位大腸直腸癌病人接受個案管理模式，包括協助聯繫病人和照護計畫之實施，並進行疾病教育、電話諮詢服務及後續護理照護和評估。對照組為325位大腸直腸癌病人，並接受常規護理。運用個案管理模式於大腸直腸癌病人，1個星期、1個月及3個月的回診遵從率顯著提升 (p=.032, p=.007, p=.001)，並有效降低大腸直腸癌病人14天再住院率（p<0.01），改善存活率。研究結果顯示，運用個案管理模式明顯優於對照組接受常規護理的照護。運用個案管理模式於大腸直腸癌病人，有效地提升了病人臨床治療的遵從率性，提高存活率及降低了14天再入院率。本研究結果可提供醫療機構推動個案管理模式於大腸直腸癌病人之參考，改善癌症病人的照護，進而提升醫療品質。

This study examines and evaluates the effect that adopting a case management model (CMM) has on the care and survival rates of Colorectal cancer (CRC) patients. In this retrospective study, 651 CRC patients were recruited between January 2006 and December 2009. The experimental group comprised 326 patients who had received care from a case management model. The case manager coordinated the recruitment, liaison, and care plan implementation, and conducted disease education, telephone consultations, follow-ups, and evaluations. The routine group comprised 325 CRC patients. The patients in the routine group had similar characteristics to those in the experimental group, and received routine care. Adopting a case management model in CRC care increased patient follow-up appointment compliance rates at the first week, first month, and third month (p=.032, p=.007, p=.001). The model also effectively reduced the patients’ 14-day readmission rate (p<0.01). Furthermore, these improvements were statistically significant. The results also indicated that the survival rate for patients receiving care from CRC. A case management model was superior to that of the routine group receiving traditional care. Adopting a CMM in CRC care effectively enhanced clinical treatment adherence, increased survival rates, and reduced the 14-day readmission rate. The results of this study may be valuable for medical institutions promoting a CMM in CRC care, improve cancer patient care, and ultimately enhance the quality of health care.