:::

詳目顯示

回上一頁
題名:照護連續性與醫療利用之相關性探討
書刊名:臺灣公共衛生雜誌
作者:黃郁清支伯生鄭守夏
作者(外文):Huang, Yu-chingChih, Po-shengCheng, Shou-hsia
出版日期:2010
卷期:29:1
頁次:頁46-53
主題關鍵詞:照護連續性醫療利用急診住院Continuity of careHealthcare utilizationEmergency department visitHospital admission
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(5) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:5
  • 共同引用共同引用:0
  • 點閱點閱:35
目標:瞭解照護連續性在沒有家庭醫師制度的台灣所呈現的狀況,並檢視較佳的照護連續性是否可以減少急診與住院的利用。方法:利用國家衛生研究院全民健康保險學術資料庫,自2006年抽樣歸人檔選取第一至五組總計20萬人資料為研究樣本,共有127,992人納入分析,資料庫中包含樣本的所有門診、急診與住院紀錄。本研究採用Bice與Boxerman所發展的照護連續性指標(Continuity of Care Index),並利用負二項式迴歸模型檢視其對急診及住院利用的影響。結果:台灣照護連續性指標平均為0.31,利用負二項式迴歸模型,控制其他變項後發現,在照護連續性高中低三組樣本中,照護連續性高者,其急診次數比照護連續性低者少了50.8%,而住院次數少了38.0%,顯示照護連續性與急診及住院利用間呈現負相關。結論:本研究結果與國際文獻相似,在台灣,照護連續性似乎也有助於健康照護結果的改善,如何提高民眾就醫的照護連續性,是值得考慮的健康照護改革方向。
Objectives: To explore the current status of continuity of care in Taiwan, and to examine the association between continuity of care and emergency visits and hospitalizations. Methods: This study used the 2006 National Health Insurance research dataset obtained from the National Health Research Institutes. A total of 127,992 persons were included in the analysis. The dataset provided information about patients’ physician visits, emergency room visits and hospitalizations. We adopted the continuity of care (COC) index developed by Bice and Boxerman for this study. Negative binominal regression was used to examine the association between COC and emergency room visits and hospital admissions while related variables were controlled for in the models. Results: The average continuity of care score in Taiwan was 0.31. The results from the regression models revealed that, among the 3 COC groups, people with high COC made 50.8% fewer emergency room visits and had 38.0% fewer hospital admissions when compared with those with low COC. Conclusions: As in previous studies, our preliminary findings imply that continuity of care improves healthcare outcome. Improving continuity of care should be an important part of future healthcare reform in Taiwan.
期刊論文
1.Breslau N、Reeb KG.(1975)。Continuity of care in a university-based practice。J Med Educ,50,965-969。  new window
2.Ejlertsson G、Berg S.(1984)。Continuity-of-care measures. An analytic and empirical comparison。Med Care,22,231-239。  new window
3.Gill, J. M.、Mainous, A. G.(1998)。The role of provider continuity in preventing hospitalizations。Arch Fam Med,7,352-357。  new window
4.Gill, J. M.、Mainous, A. G. III、Nsereko, M.(2000)。The effect of continuity of care on emergency department use。Archives of Family Medicine,9(4),333-338。  new window
5.Haggerty, J. L.、Reid, R. J.、Freeman, G. K、Starfield, B. H.、Adair, C. E.、McKendry, R.(2003)。Continuity of care:A multidisciplinary review。British Medical Journal,327(7425),1219-1221。  new window
6.Christakis, D. A.、Wright, J. A.、Koepsell, T. D.、Emerson, S.、Connell, F. A.(1999)。Is greater continuity of care associated with less emergency department utilization?。Pediatrics,103(4),738-742。  new window
7.Ionescu-Ittu, R.、McCusker, J.、Ciampi, A.(2007)。Continuity of primary care and emergency department utilization among elderly people。CMAJ,177,1362-1368。  new window
8.Christakis, D. A.、Mell, L.、Koepsell, T. D.、Zimmerman, F. J.、Connell, F. A.(2001)。Association of lower continuity of care with greater risk of emergency department use and hospitalization in children。Pediatrics,107,524-529。  new window
9.Cree, M.、Bell, N. R.、Johnson, D.、Carriere, K. C.(2006)。Increased continuity of care associated with decreased hospital care and emergency department visits for patients with asthma。Dis Manag,9,63-71。  new window
10.Jee, S. H.、Cabana, M. D.(2006)。Indices for continuity of care: a systematic review of the literature。Medical Care Research and Review,63(2),158-188。  new window
11.Bice, T. W.、Boxerman, S. B.(1997)。A quantitative measure of continuity of care。Med Care,15,347-349。  new window
12.De Maeseneer, J. M.、De Prins, L.、Gosset, C.、Heyerick, J.(2003)。Provider continuity in family medicine: does it make a difference for total health care costs?。Annals of Family Medicine,1,144-148。  new window
13.Steinwachs DM.(1979)。Measuring provider continuity in ambulatory care。Med Care,17,551-65。  new window
14.Dietrich AJ, Marton KI.(1982)。Does continuous care from a physician make a difference?。J Fam Pract,15,929-37。  new window
15.Starfield, B.(1980)。Continuous confusion?。Am J Public Health,70,117-119。  new window
16.Starfield BH, Simborg DW, Horn SD, Yourtee SA.(1976)。Continuity and coordination in primary care: their a chievement and utility。Med Care,14,625-36。  new window
17.Starfield, B.、Simborg, D.、Johns, C.、Horn, S.(1977)。Coordination of care and its relationship to continuity and medical records。Medical Care,15(11),929-938。  new window
18.Ejlertsson G, Berg S.(1985)。Continuity of care in health care teams. A comparison of continuity measures and organizational solutions。Scand J Prim Health Care,3,79-85。  new window
19.Eriksson EA, Mattsson LG.(1983)。Quantitative measurement of continuity of care. Measures in use and an alternative approach。Med Care,21,858-75。  new window
20.Hanninen J, Takala J, Keinanen-Kiukaanniemi S.(2001)。Good continuity of care may improve quality of life in Type 2 diabetes。Diabetes Res Clin Pract,51,21-7。  new window
21.Sturmberg, J.(2000)。Continuity of care: towards a definition based on experiences of practising GPs。Fam Pract,17,16-20。  new window
22.Shear CL, Gipe BT, Mattheis JK, Levy MR.(1983)。Provider continuity and quality of medical care. A retrospective analysis of prenatal and perinatal outcome。Med Care,21,1204-10。  new window
23.Alpert JJ, Robertson LS, Kosa J, Heagarty MC,Haggerty RJ.(1976)。Delivery of health care for children: report of an experiment。Pediatrics,57,917-30。  new window
24.Mainous, A. G. Ⅲ、Gill, J. M.(1998)。The importance of continuity of care in the likelihood of future hospitalization: is site of care equivalent to a primary clinician?。Am J Public Health,88,1539-1541。  new window
25.O’Malley AS Forrest CB.(1996)。Continuity of care and delivery of ambulatory services to children in community health clinics。J Community Health,21,159-73。  new window
26.Eriksson EA.(1990)。Continuity-of-care measures. Random assignment of patients to providers and the impact of utilization level。Med Care,28,180-90。  new window
27.Perrin EC, Newacheck P, Pless IB, et al.(1993)。Issues involved in the definition and classification of chronic health conditions。Pediatrics,91,787-93。  new window
28.Brousseau DC, Meurer JR, Isenberg ML, Kuhn EM, Gorelick MH.(2004)。Association between infant continuity of care and pediatric emergency department tutilization。Pediatrics,113,738-41。  new window
研究報告
1.Reid R, McKendry R, Haggerty J.(2002)。Defusing the Confusion: Concepts and Measures of Continuity of Healthcare。Ottawa。  new window
 
 
 
 
第一頁 上一頁 下一頁 最後一頁 top
:::
無相關博士論文
 
無相關書籍
 
無相關著作
 
QR Code
QRCODE