比較呼吸照護病房與居家照護對長期呼吸器依賴病患之成效

Comparing the Effects of Respiratory Care Ward and Home Care for Long-term Ventilator - dependent Patients

10.6320/FJM.2002.6(4).06

李麗琴(Lih-Chyn Lee)；盧美秀(Meei-Shiow Lu)；張文英(Wen-Yin Chang)；湯澡薰(Tzao-Shiun Tang)；吳子卿(Tzu-Chin Wu)

長期呼吸器依賴 ； 成本 ； 照護成果 ； 滿意度 ； long-term ventilator-dependent ； cost ； care outcome ； satisfaction

台灣醫學

6卷4期（2002 / 07 / 01）

514 - 522

繁體中文

The design was descriptive comparative analysis. The purpose of this study was to compare the effects between ventilator-dependent patients cared at respiratory care ward (RCW) and at home (HC). A purposive sampling was used to collect data from stable long-term ventilator-dependent patients who met the criteria for national insurance coverage integrated care plan and lived in central areas of Taiwan. A structured questionnaire and regular 2-3 months home or telephone interviews were used to understand the differences in care costs, care outcomes, and caregivers' satisfaction. Thirty patients from RCW and 30 from HC were recruited in this study. The results indicated as follows. 1.A statistical significant difference was found between RCW and HC in which patients in RCW were older, higher education, more married, and more number of children, but less months of ventilator used than HC patients. 2.The total cost of RCW (NT154,696) was higher than those cared at home (NT64,742). The health care costs were the major costs of RCW and possessed 87 % of total costs. 3. A statistical significant difference was found in both infection rate and returned rate between these two groups (p＜0.02). The infection rate was reported 3.7 times per person for patients at RCW and 1.32 times per person at HC. For the returned rate, the RCW (M=0.13) was lower than those of patients cared at home (M=0.76). 4. For the main caregiver's satisfaction, although the score of satisfaction was slightly higher at RCW, it was not reach the significant level. Only emergency care, respiratory therapists, professional physicians, overall care, and economic burden of the family were shown significant differences between these two groups (p＜ 0.05). Because the HC for long-term ventilator-dependent patients was more cost-effective, the results may provide valuable information for policy decision-making in planning long-term ventilator-dependent care. Moreover, encouraging home care is needed to improve the quality of long-term ventilator-dependent care and to reduce the health care expenditure in the future.

The design was descriptive comparative analysis. The purpose of this study was to compare the effects between ventilator-dependent patients cared at respiratory care ward (RCW) and at home (HC). A purposive sampling was used to collect data from stable long-term ventilator-dependent patients who met the criteria for national insurance coverage integrated care plan and lived in central areas of Taiwan. A structured questionnaire and regular 2-3 months home or telephone interviews were used to understand the differences in care costs, care outcomes, and caregivers' satisfaction. Thirty patients from RCW and 30 from HC were recruited in this study. The results indicated as follows. 1.A statistical significant difference was found between RCW and HC in which patients in RCW were older, higher education, more married, and more number of children, but less months of ventilator used than HC patients. 2.The total cost of RCW (NT154,696) was higher than those cared at home (NT64,742). The health care costs were the major costs of RCW and possessed 87 % of total costs. 3. A statistical significant difference was found in both infection rate and returned rate between these two groups (p＜0.02). The infection rate was reported 3.7 times per person for patients at RCW and 1.32 times per person at HC. For the returned rate, the RCW (M=0.13) was lower than those of patients cared at home (M=0.76). 4. For the main caregiver's satisfaction, although the score of satisfaction was slightly higher at RCW, it was not reach the significant level. Only emergency care, respiratory therapists, professional physicians, overall care, and economic burden of the family were shown significant differences between these two groups (p＜ 0.05). Because the HC for long-term ventilator-dependent patients was more cost-effective, the results may provide valuable information for policy decision-making in planning long-term ventilator-dependent care. Moreover, encouraging home care is needed to improve the quality of long-term ventilator-dependent care and to reduce the health care expenditure in the future.