影響長期照護十年計畫照管專員核定居家服務時數之因素探討

陳星翰; 葉馨婷; 吳肖琪

doi:10.6317/LTC.201805_22(1).0005

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P33 - 51

医药卫生 > 预防保健与卫生学
医药卫生 > 社会医学

DOI： 10.6317/LTC

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影响长期照护十年计画照管专员核定居家服务时数之因素探讨

The Variation of Approved Home Care Service Hours for Disabled Elderly among Care Managers under Ten-Year Long-Term Care Program

陈星翰(Xing-Han Chen) ；叶馨婷(Shin-Ting Yeh) ；吴肖琪(Shiao-Chi Wu)

长期照护杂志； 22 卷 1 期 (2018 / 05 / 01) ， P33 - 51

繁体中文 DOI： 10.6317/LTC.201805_22(1).0005

照管专员；居家服务；照顾服务员；居家服务核定时数；标准特质；非标准特质； care manager ； home care service ； nurse aide ； approved home care service hours ； standard characteristics ； nonstandard characteristics

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摘要 │ 参考文献 (39) │ 被引用文献 (1) │ 国际计量

摘要〈TOP〉

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Objective: To investigate the effect of standard and nonstandard characteristics on the approved home care service hours for disabled elderly among care managers under Ten-Year Long-term Care Program. Method: A cross-sectional design was used to investigate the factors related to the approved home care service hours in disabled elderly in 2013. Disability level and cognitive function were used as standard characteristics, whereas the characteristics of home care cases and their family caregivers, the workload of care managers, and the region resources served as nonstandard variables. Data analyses were conducted using a generalized estimating equation (GEE) because some subjects were repeatedly observed in the ten-year plan of long-term care database. Results: The monthly average approved home care service hours for disabled elderly in 2013 was 29.1 hours. Subjects with mild, moderate, and severe disabilities were 16.1, 29.8, and 39.1 hours, respectively. The approved home care service hours were significantly higher in the subjects with more severe disability, older, disability card, married, living with family members, good care quality, high burden of family caregivers and numbers of nurse aide in different county/city. The explanatory power of initial model included the level of disability and cognitive function was 20.66%. After controlling the characteristics of disabled elderly and their family caregivers, the workload of care managers, the resources of nurse aide in region, and county/city, the explanatory power were 24.64%, 24.74%, 25.88%, and 31.38%, respectively. Conclusion: The approved home care service hours for the disabled elderly was inconsistency, and with low R-squared. Besides of standard characteristics of disabled elderly, nonstandard characteristics such as age, with disability card, without spouse, live with family members, good care quality and high burden of family caregivers, living in different city/county were associated with approved home care service hours. Therefore, multi-dimensional assessment tool were needed in long term care program Version 2.0. However, the manpower of nurse aide was the key variable to influence the home care service hours among county/city. We suggested government should play more attention on the amount and stability of the market of nurse aide.

参考文献 ( 39 ) 〈TOP〉

Babineau, K.,Taylor, K.,Clancy, L.(2015).Electronic cigarette use among Irish youth: A cross sectional study of prevalence and associated factors.PLoS One,10(5),e0126419.
Caplan, A. L.(Ed.)(1993).Ethical conflicts in the management of home care: The case manager's dilemma.New York, NY:Springer Publishing Company.
Corazzini, K.(2003).How state‐funded home care programs respond to changes in medicare home health care: Resource allocation decisions on the front line.Health Services Research,38(5),1263-1282.
Corazzini-Gomez, K.(2002).The relative effects of home care client characteristics on the resource allocation process: Do personality and demeanor matter?.The Gerontologist,42(6),740-750.
Crook, W. P.,Vinton, L.(2000).A study of case managers' decision-making processes.CareManagement Journals,2(4),211-215.

被引用文献 ( 1 ) 〈TOP〉

许世欣(2018)。衔接长照2.0出院准备服务友善医院～无缝接轨、出院到家、服务即到家～。彰化护理，25(3)，113-114。

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