長照2.0核定專業服務與退出居家復能服務使用者特性之探討

Exploring the characteristics of care recipients approving professional services and discontinuing home-based reablement under long-term care 2.0

目標：本研究目的為了解現行長照體制下專業服務與居家復能使用者特性。方法：本研究採用次級資料庫分析，以安德森健康服務利用行為模式為架構，資料來源為長照2.0制度下南部某都市照顧管理資訊平台資料庫。以描述性及多元羅吉斯迴歸分析探討使用者特性與服務利用之關係。結果：研究結果分為兩大面向，分別為：（一）核定專業服務之使用者特性：居住區域為都會核心、A個管類型為醫事個管單位、個案年齡較輕、教育程度較高、家屬照顧負荷較低、有聘請看護、個案失能等級越高等因素與專業服務核定顯著相關。（二）退出居家復能服務個案之特性：年齡越高、與照顧者同住、無聘請看護、失能等級輕中度以及其他長照資源越多之個案較有退出居家復能服務可能性。結論：本研究針對個案特性實證結果可以作為未來專業服務輸送之參考，希望藉由了解目專業服務推動與服務使用現況，提升制度端對於專業服務的決策制定並有助針對民眾推廣復能服務的效益。（台灣衛誌 2022；41（2）：170-188）

Objectives: This study explored care recipients’ characteristics in relation to Taiwan’s “Professional Services and Home-Based Reablement Under Long-Term Care 2.0” plan. Methods: Data were extracted from the care management information database of the long-term care system in Taiwan, and secondary data analysis was performed. Descriptive statistics and multiple logistic regression were used to analyze the factors affecting outcomes. Results: The study revealed the following two main results: (1) Factors significantly influencing care recipients’ approval of the relevant professional services were residential area, type of A care management unit, a younger age, a higher level of education, a lower level of caregiver burden, having a foreign care worker, and a higher dependency level. (2) The characteristics of care recipients who were likely to discontinue their participation in home-based reablement plans were age, living with family caregivers, not having a foreign live-in caregiver, having mild to moderate disabilities (long-term care CMS level), and greater long-term care resource availability. Conclusions: Policy makers can use the care recipient characteristics identified in this study as a reference for developing an effective intervention model for the long-term care of care recipient groups in the community to meet the needs of both care recipients and their caregivers. (Taiwan J Public Health. 2022;41(2):170-188)