题名

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

并列篇名

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

DOI

10.6288/TJPH.202204_41(2).110135

作者

黃亭穎(Ting-Ying Huang);劉立凡(Li-Fan Liu);張玲慧(Ling-Hui Chang);林佩欣(Pay-Shin Lin);郭佳吟(Chia-Yin Kuo)

关键词

長期照護 ; 居家復能 ; 復能服務利用 ; 使用者特性 ; 安德森健康服務利用行為模式 ; long-term care ; reablement ; utilization ; user characteristics ; Andersen's Behavioral Model of Health Services Use

期刊名称

台灣公共衛生雜誌

卷期/出版年月

41卷2期(2022 / 04 / 29)

页次

170 - 188

内容语文

繁體中文

中文摘要

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。

英文摘要

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.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Liu, LF,Chen, JJ,Lee, YC,Liu, CC(2018).Exploring the home services utilization and its influencing factors for case closures in Taiwan long-term care system.Taiwan J Public Health,37,539-553.
    連結:
  2. 王俞樺, YH,劉立凡, LF(2020)。機構照護新思維─台灣長照機構推動生活自立支援對能力回復與生活品質之成效探討。商略學報,12,211-226。
    連結:
  3. 侯佩君, PC,杜素豪, SH,廖培珊, PS,洪永泰, YT,章英華, YH.(2008)。台灣鄉鎮市區類型之研究:〔台灣社會變遷基本調查〕第五期計畫之抽樣分層效果分析。調查研究─方法與應用,23,7-32。
    連結:
  4. 施姵宇, PY,古鯉榕, LJE,白明奇, MC,劉立凡, LF(2017)。失智症家庭使用長期照顧服務的情形與不使用的原因。台灣衛誌,36,375-385。
    連結:
  5. 紀玫如, MJ,莊坤洋, KY,吳振龍, CL,吳淑瓊, SC(2006)。居家服務使用之相關因素研究。台灣衛誌,25,37-48。
    連結:
  6. 黃郁超, YC, ,吳建賢, CH,張淑惠, SH,陳雅美, YM(2016)。外籍看護與家庭照顧者對接受居家照顧老人住院與死亡風險之差異。台灣衛誌,35,304-315。
    連結:
  7. 蔡宜蓉, AYJ,毛慧芬, HF,林佳萱, CH,李玉春, YC,張玲慧, LH(2021)。以質性研究探討台灣推動復能服務之困境與因應策略-從服務提供者觀點分析。台灣衛誌,40,394-405。
    連結:
  8. 羅玉岱, YT,林沛嫻, PH,張春瑤, CT,江怡慧, IH(2011)。居家失能患者使用長期照顧十年計畫服務之現況。台灣家庭醫學雜誌,21,79-92。
    連結:
  9. Andersen, RM(1995).Revisiting the behavioral model and access to medical care: does it matter?.J Health Soc Behav,36,1-10.
  10. Andersen, RM(2008).National health surveys and the behavioral model of health services use.Med Care,46,647-653.
  11. Cochrane, A,Furlong, M,McGilloway, S,Molloy, DW,Stevenson, M,Donnelly, M(2016).Time-limited home-care reablement services for maintaining and improving the functional independence of older adults.Cochrane Database Syst Rev,10,CD010825.
  12. Cochrane, A,McGilloway, S,Furlong, M,Molloy, DW,Stevenson, M,Donnelly, M(2013).Home-care’re-ablement’ services for maintaining and improving older adults’ functional independence (Protocol).The Cochrane Library,11,1-12.
  13. Fu, YY,Guo, Y,Bai, X,Chui, EWT(2017).Factors associated with older people’s long-term care needs: a case study adopting the expanded version of the Anderson Model in China.BMC Geriatr,17,38.
  14. Jokstad, K,Skovdahl, K,Landmark, BT,Haukelien, H(2019).Ideal and reality; Community healthcare professionals’ experiences of user-involvement in reablement.Health Soc Care Community,27,907-916.
  15. Kyaw, K(2020).Association of long-term care utilization and functional ability in older adults.Eur J Public Health,30(Suppl 5),ckaa165.552.
  16. Lewin, GF,Alfonso, HS,Alan, JJ(2013).Evidence for the long term cost effectiveness of home care reablement programs.Clin Interv Aging,8,1273-1281.
  17. Li, IC,Fann, Sl,Kuo, HT(2011).Predictors of the utilization of long-term care (LTC) services among residents in community-based LTC facilities in Taiwan.Arch Gerontol Geriatr,53,303-308.
  18. Liu, LF(2014).The health heterogeneity of and health care utilization by the elderly in Taiwan.Int J Environ Res Public Health,11,1384-1397.
  19. Liu, LF(2009).Characteristics of the home service utilization for older adults in Taiwan.Taiwan Geriatr Gerontol,4,187-202.
  20. Mishra, V,Barratt, J.(2016).,Copenhagen:International Federation on Ageing.
  21. Park, JM(2015).Equity of access under Korean national long-term care insurance: implications for long-term care reform.Int J Equity Health,14,82.
  22. Rabiner, DJ(1995).Patterns and predictors of noninstitutional health care utilization by older adults in rural and urban America.J Rural Health,11,259-273.
  23. Reckrey, JM,DeCherrie, LV,Kelley, AS,Ornstein, K(2013).Health care utilization among homebound elders: does caregiver burden play a role?.J Aging Health,25,1036-1049.
  24. Slobbe, LCJ,Wong, A,Verheij, RA,van Oers, HAM,Polder, JJ(2017).Determinants of first-time utilization of long-term care services in the Netherlands: an observational record linkage study.BMC Health Serv Res,17,626.
  25. Tessier, A,Beaulieu, MD,Mcginn, CA,Latulippe, R.(2016).Effectiveness of reablement: a systematic review.Healthcare Policy,11,49-59.
  26. Travers, JL,Hirschman, KB,Naylor, MD(2020).Adapting Andersen’s expanded behavioral model of health services use to include older adults receiving longterm services and supports.BMC Geriatr,20,58.
  27. Tuntland, H,Kjeken, I,Langeland, E(2017).Predictors of outcomes following reablement in community-dwelling older adults.Clin Interv Aging,12,12-63.
  28. Wang, L,Di, X,Yang, L,Dai, X(2020).Differences in the potential accessibility of home-based healthcare services among different groups of older adults: a case from Shaanxi Province, China.Healthcare,8,452.
  29. Wee, SL,Hu, AJ,Yong, J,Chong, WF,Raman, P,Chan, A(2015).Singaporeans’ perceptions of and attitudes toward long-term care services.Qual Health Res,25,218-227.
  30. Winkel, A,Langberg, H,Wæhrens, EE(2015).Reablement in a community setting.Disabil Rehabil,37,1347-1352.
  31. Wu, CY,Hu, HY,Huang, N,Fang, YT,Chou, YJ,Li, CP(2014).Determinants of long-term care services among the elderly: a population-based study in Taiwan.PLoS One,9,e89213.
  32. Yang, D,Dalton, JE.(2012).A unified approach to measuring the effect size between two groups using SAS®.Proceedings of SAS Global Forum
  33. Yu, HW,Tu, YK,Chen, YM(2019).Sociodemographic characteristics, disability trajectory, and health care and long-term care utilization among middle-old and older adults in Taiwan.Arch Gerontol Geriatr,82,161-166.
  34. 毛慧芬, HF,張玲慧, LH,蔡宜蓉, YJ(2020)。長期照顧 2.0復能照護服務-觀念的翻轉與挑戰。台大護理雜誌,16,5-16。
  35. 江清馦, CH.(2009)。,台北=Taipei:行政院經濟建設委員會=Council for Economic Planning and Development, Executive Yuan, R.O.C. (Taiwan)。
  36. 李宜玲, YL,李世代, SD,曹昭懿, JY,胡名霞, MH(2018)。居家物理治療服務利用影響因素之探討-以台北都會區失能者為例。物理治療,43,215-228。
  37. 林怡臻, YJ(2019)。台北=Taipei,國立陽明大學衛生福利研究所=Institute of Health and Welfare Policy, National Yang-Ming University。
  38. 陳麗如, LJ,周姚均, YC,楊美如, MJ(2018)。個管師於社區整合照顧服務之經驗。北市醫學雜誌,15,21-27。
  39. 衛生福利部:長照復能服務操作指引─觀念篇。https://1966.gov.tw/LTC/cp-4444-47438-201.html。引用2021/10/14。 Ministry of Health and Welfare, R.O.C. (Taiwan). Long-term care rehabilitation service-related operation instructions: concepts. Available at: https://1966.gov.tw/LTC/cp-4444-47438-201.html. Accessed October 14, 2021. [In Chinese]
  40. 衛生福利部:長期照顧(照顧服務、專業服務、交通接送服務、輔具服務及居家無障礙環境改善服務)給付及支付基準。https://1966.gov.tw/LTC/cp-4212-44992-201.html。引用2021/10/14。 Ministry of Health and Welfare, R.O.C. (Taiwan). Long-term care (care services, professional services, transportation services, assistive device services, and services for improving home-based accessible environments) benefits and payment criteria. Available at: https://1966.gov.tw/LTC/cp-4212-44992-201.html. Accessed October 14, 2021. [In Chinese]
  41. 衛生福利部:社會福利及衛生環境委員會「長照2.0執行現況及檢討」專案報告。https://www.mohw.gov.tw/dl-64981-86dfd40d-7294-40d6-b914-52ac5483b43d.html。引用2021/10/14。 Ministry of Health and Welfare, R.O.C. (Taiwan). Project report on the current situations and review of long-term care 2.0 implementation by the Social Welfare and Environmental Hygiene Committee. Available at: https://www.mohw.gov.tw/dl-64981-86dfd40d-7294-40d6-b914-52ac5483b43d.html. Accessed October 14, 2021. [In Chinese]