Dissertation/ Thesis
Care Quality of the Elderly between Home and Institution －after Long-term Care Ten-year Program
| العنوان: | Care Quality of the Elderly between Home and Institution －after Long-term Care Ten-year Program |
|---|---|
| Alternate Title: | 居家與機構間照護品質之探討-長照十年計劃實施後 |
| المؤلفون: | Guo-Hong Li, 李果鴻 |
| Thesis Advisors: | Shiao-Chi Wu, 吳肖琪 |
| سنة النشر: | 2015 |
| المجموعة: | National Digital Library of Theses and Dissertations in Taiwan |
| الوصف: | 103 Background: After 2008, government of Taiwan implemented some long-term care policies. For example, long-term care ten-year program, overall care facilities assessment and assessments integration. These are all for building more complete net of care services and promoting care quality. There were some studies show the difference in care quality between at home and in facilities before 2008, such as facilities have more risk of urinary tract infection and lower respiratory tract infection and home has more risk of pressure ulcer. After new long-term care policies implemented, we want to investigate that were there still difference in care quality between home and facilities? Objectives: To analyze the difference in care quality between home and facilities in one-year. Methods: Using the National Health Insurance Databases 2007 to 2010 to conduct a retrospective cohort study. The subjects are new old cases (older than 65 years-old) of National Health Insurance Home Care in 2008 and 2009. Then use propensity score including cases’ sex, age and CCI (Charlson Comorbidity Index ) to 1:1 match home group and facility group (each were 17,649 subjects). Using Cox proportional hazard model to analyze whether there were any difference in care quality between home and facilities in one-year. Results: In facilities group, the risk of urinary tract infection (HR=1.15) and lower respiratory tract infection (HR=1.19) were significantly higher than home group. In home group, the risk of pressure ulcer (facility group HR=0.72) was significantly higher than facility group. There were no difference of fracture and hip fracture between home and facility. In high volume facilities, the risk of urinary tract infection, lower respiratory tract infection, fracture and pressure ulcer were lower than low volume facilities. Conclusions: There were different care quality between home and facility. Here are some suggestions, for Primary management department of health administration, first, invesrigate the use rate of long-term care ten-year program, second, enhance the management and guidance of low volume facility, third, promote the quality of service supplier, fourth, promote the long-term care literacy of people. For service supplier, first, implement hand hygiene to prevent urinary tract infection, second, help case link to long-term care resourse such as pressure relief shim and electrically operated bed. |
| Original Identifier: | 103YM005599002 |
| نوع الوثيقة: | 學位論文 ; thesis |
| وصف الملف: | 85 |
| الاتاحة: | http://ndltd.ncl.edu.tw/handle/3jkba8 |
| رقم الانضمام: | edsndl.TW.103YM005599002 |
| قاعدة البيانات: | Networked Digital Library of Theses & Dissertations |
| الوصف غير متاح. |