| 英文摘要 |
Chronic obstructive pulmonary disease (COPD) imposes a significant and increasing socioeconomic burden. In the year 2017, the Ministry of Health and Welfare included COPD as part of the healthcare payment improvement program, and the Joint Commission of Taiwan introduced disease care quality certification. According to the World Health Organization (WHO) statistics, COPD ranks as the third leading cause of death globally. Repeated acute exacerbations lead to extended hospital stays, increased healthcare expenditures, and even higher mortality rates. To provide comprehensive and continuous care for COPD patients and improve their prognosis, our team set the goal of ''increasing the rates of case management for COPD''. In 2019, at a regional hospital in the northern Taiwan, a total of 186 individuals met the criteria for COPD admission, but only 65 were admitted, accounting for a rate of 34.9% of the total eligible cases. This rate was lower than the admission rate for asthma, a related respiratory disease, in the same region in the year 2019. Therefore, taking this benchmark and our team's self-expectations into account, we set the improvement target at 59.2%. After conducting personnel perception surveys and examining the admission process, we identified key root causes using the Pareto principle. We developed strategies to address the ''personnel,'' ''system,'' and ''equipment'' aspects for improvement. Evaluation results showed that the COPD admission rate increased to 74%, the screening time for patients decreased by 81.8%, the average medical cost per patient decreased by 98.8%. Through this improvement initiative, we not only enhanced case management efficiency but also increased the patient admission rate, providing comprehensive and continuous care. In the future, it is important to maintain and monitor the effectiveness of admissions to achieve a win-win situation for patients, hospitals, and healthcare expenditures. |
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