Exploring the Associations between Long-Term Care and Mortality Rates among Stroke Patients

Kun-Yang Chuang; Shwu-Chong Wu; Yeh Mei Chang; Yu-Hui Chen; Chen-Long Wu

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P66 - 74

医药卫生 > 预防保健与卫生学
医药卫生 > 社会医学

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Exploring the Associations between Long-Term Care and Mortality Rates among Stroke Patients

中风病人长期照护与死亡率之相关性探讨

庄坤洋(Kun-Yang Chuang) ；吴淑琼(Shwu-Chong Wu) ；张媚(Yeh Mei Chang) ；陈育慧(Yu-Hui Chen) ；吴振龙(Chen-Long Wu)

The Journal of Nursing Research ； 13 卷 1 期 (2005 / 03 / 01) ， P66 - 74

英文

长期照护；死亡率；中风； long-term care ； mortality ； stroke

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摘要 │ 参考文献 (33) │ 国际计量

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Information on types of long-term care received by stroke patients after hospital discharge is essential for the formulation of long-term care resource development policy. Comparisons of outcomes resulting from different types of long-term care can provide important considerations in the selection of long-term care services. The purpose of this study is to describe the patterns of long-term care received, and to explore if associations exist between long-term care services and mortality status among stroke patients after hospital discharge. Using a longitudinal quasi-experimental study design, this study collected information on the type of long-term care received at 1, 3, and 6 months after discharge for 714 patients. At one month after discharge, 4.5% had died, and 22.1% had regained all functions in activities of daily living and instrumental activities of daily living. The percentage of patients receiving institutional care, home or community-based care, and family care only were 10.4%, 22.4%, and 40.7% respectively. The respective percentages at 3 months after discharge were 11.2%, 18.7%, and 38.0%, and, at 6 months after discharge, 10.3%, 19.4%, and 30.9%. After adjusting for age, sex, previous incidence of stroke, and physical functions, the odds of dying within 6 months after discharge for stroke patients receiving home or community-based care was significantly lower than those in institutions (OR = 0.39; 95% CI = 0.15 to 0.97). It is not clear why a lower mortality rate was observed among patients receiving home or community-based services. Differences in quality of care and quality of life among users of different types of long-term care services should be investigated. More research is needed to assess the causes of the disparity in mortality rates among users of different types of long-term care services.

参考文献 ( 33 ) 〈TOP〉

Andersen, H. E.,Schultz-Larsen, K.,Kreiner, S.,Forchhammer, B. H.,Eriksen, K.,Brown, A.(2000).Can readmission after stroke be prevented? Results of a randomized clinical study: A postdischarge follow-up service for stroke survivors.Stroke,31(5),1038-1045.
Brown, R. D.,Ransom, J.,Hass, S.,Petty, G. W.,O''Fallon,W. M.,Whisnant, J. P.(1999).Use of nursing home after stroke and dependence on stroke severity: A population-based analysis.Stroke,30(5),924-929.
Chiu, L.,Shyu, W. C.,Chen, T. R.(1997).A cost-effectiveness analysis of home care and community-based nursing homes for stroke patients and their families.Journal of Advanced Nursing,26(5),872-878.
Labor statistics: Number of foreign laborers in Taiwan-by occupation
Crawford, V. L.,Beringer, T. R.,Stout, R. W.(1999).Comparison of residential and nursing home care before and after the 1993 community care policy.British Medical Journal,318(7180),366.

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