THE ASSESSMENT OF A HOSPITAL-BASED CARE MANAGEMENT MODEL FOR LONG-TERM CARE SERVICES

Abstract

本研究旨在評估醫院型照護管理模式對功能障礙老人之成效。用縱貫式類實驗研究設計，研究對象爲居住在台北市大案行政區之功能障礙老人共331位，失道寡助照顧管理模式服務者爲實驗組，計166人，未接受服務者爲對照組，計165人，並於照顧管理模式服務介入前與介入後收集相關資料。使用邏輯式回歸分析探討照顧管理模式的介入對醫療費用、自評健康及對長期護之滿意度的相關性。研究主要發現照顧管理模式介入一年後，相較於對照組，實驗組比較可減少醫療費用支出，並維持或增加其對長期照護報務的滿意度，其差異均達到統計上顯著相關，但在自評健康方面則無相關性存在。綜而言之，醫院型照顧管理模式服務減少功能障礙老人在醫療服務的使用，及提昇個案與照顧者的滿意度，並爲連結長期照護服務之重要轉介單位，起泡沫爲應落實建立一套健全之照顧管理模式，並評估其成效。 The purpose of this research was to assess the effectiveness of a hospital-based care management model on disabled elderly people. A before-and-after quasi- experimental design was adopted. A total of 331 disabled elderly people, residing in the Da-An District of Taipei City, participated in the study. Among them, 166 received care management, while the other 165 did not. The latter served as controls Baseline and follow-up data collection were carried out before and after care management intervention. Logistic regression analysis was used to test the effects of care management on medical care expenditure, self-rated health, and satisfaction with long-term care arrangement. The results showed that those under care management, compared to the controls, were more likely to experience a decrease in medical care expenditure, and less likely to have a decrease in satisfaction with long-term care. The effects were statistically significant. However, there was no effect on self-rated health. The findings show that hospital-based care management is a viable option and has the potential to become an important segment in the delivery of long-term care services. More effort should be expended in its development and in the evaluation of its effectiveness.