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題名:長短期失能個案居家物理治療服務利用與療效--以臺北都會區為例
書刊名:臺灣公共衛生雜誌
作者:李宜玲李世代 引用關係曹昭懿胡名霞
作者(外文):Li, Yi-lingLee, Shyh-dyeTsauo, Jau-yihHu, Ming-hsia
出版日期:2015
卷期:34:6
頁次:頁657-669
主題關鍵詞:失能居家物理治療服務利用長期照護急性後期照護DisabilityHome-based physical therapyUtilizationLong-term carePost-acute care
原始連結:連回原系統網址new window
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目標:比較長短期失能居家個案之物理治療服務利用及療效之異同,以供日後急性後期照護與長期照護居家物理治療服務政策推動參考。方法:以2012年台北市與新北市無記名居家物理治療資料進行次級分析。走路、洗澡、穿衣與轉位等任一項身體功能,失能超過6個月者定義為長期失能,其餘為短期失能。以t檢定與卡方檢定比較長短期失能個案特徵、物理治療介入次數及巴氏量表得分改善情形,並以羅吉斯迴歸分析各診斷(或處置)個案之失能期長短和功能改善與否之關聯性。結果:717筆個案資料中,長、短期失能個案比例約為7比3。短期失能個案之疼痛、關節受限與轉介前功能較獨立之比例較高。居家物理治療的平均介入次數為5.4 ± 3.2次,長、短期失能個案的服務利用分別為5.5 ± 3.2次及5.2 ± 3.2次,無統計上的顯著差異。介入後,個案的巴氏量表得分平均改善6.0 ± 13.0分,短期失能個案功能改善顯著優於長期失能個案,巴氏量表分別增加8.9 ± 15.6分與4.8 ± 11.7分(p < 0.01)。與長期失能個案相比,短期失能個案功能改善之勝算比,在中風個案為2.28(p=0.007),在關節置換個案為7.28(p=0.011)。結論:長短期失能個案的居家物理治療介入次數相當,但短期失能個案療效較佳。中風、關節置換的短期失能個案進步情況尤其顯著。
Objectives: This study compared differences in the characteristics, utilization, and outcomes of home-based physical therapy (HPT) between clients with long- and short-term disabilities. Methods: A secondary analysis was conducted on data collected from routine records of HPT in the Taipei metropolitan region in 2012. Clients who had disabilities in walking, dressing, bathing, and transferring for > 6 months were classified as having a long-term disability; the remaining clients were classified as having a short-term disability. The data included socio-demographic data, health functional status, intervention sessions, and Barthel Index (BI) scores. We used t-tests, chisquare tests, and multiple logistic regression models to analyze the differences between long- and short-term disabilities. Results: Delinked data of 717 subjects were included. The ratio of longversus short-term clients with disabilities was approximately 7:3. Significantly more clients with short-term than long-term disabilities reported pain, limited range of motion, and less functional dependence before intervention. The intervention frequency (average, 5.4 ± 3.2 sessions) was similar between groups. After HPT intervention, the average improvement in BI score was 6.0 ± 13.0. The improvements in ADL were significantly greater in the clients with short-term disabilities than the clients with long-term disabilities (8.9 ± 15.6 vs. 4.8 ± 11.7, respectively). The odds ratios between clients with short- and long-term disabilities were 2.28 (p=0.007) for stroke patients and 7.28 (p=0.011) for patients who have undergone arthroplasties. Conclusions: The number of intervention sessions between the clients with long- and short-term disabilities were similar. The effectiveness of HPT intervention was better for clients with short- than long-term disabilities, especially for patients who had undergone arthroplasties or had strokes.
期刊論文
1.Buntin, M. B.、Colla, C. H.、Escarce, J. J.(2009)。Effects of payment changes on trends in post-acute care。Health Services Research,44(4),1188-1210。  new window
2.李宜玲、胡名霞(20120900)。居家物理治療對失能老人之介入與療效。物理治療,37(3),277-289。  延伸查詢new window
3.林昭宏、謝清麟、盧成皆、柴惠敏、廖龍仁(20040100)。Preliminary Study of the Effect of Low-Intensity Home-Based Physical Therapy in Chronic Stroke Patients。The Kaohsiung Journal of Medical Sciences,20(1),18-23。  new window
4.Morita, H.、Iso, H.、Hashimoto, J.(2009)。Long-term effects of low-frequency home-visit rehabilitation by cooperation with physiotherapists and health care and welfare workers on activities of daily living。J Phys Ther Sci,21,13-22。  new window
5.Hung, L. C.、Liu, C. C.、Hung, H. C.、Kuo, H. W.(2003)。Effects of a nursing intervention program on disabled patients and their caregivers。Arch Gerontol Geriatr,36,259-272。  new window
6.Jörger, M.、Beer, S.、Kesselring, J.(2001)。Impact of neurorehabilitation on disability in patients with acutely and chronically disabling diseases of the nervous system measured by the extended Barthel Index。Neurorehabil Neural Repair,15,15-22。  new window
7.Russell, D.、Rosati, R. J.、Andreopoulos, E.(2012)。Continuity in the provider of home-based physical therapy services and its implications for outcomes of patients。Phys Ther,92,227-235。  new window
8.Quan, H.、Sundararajan, V.、Halfon, P.、Fong, A.、Burnand, B.、Luthi, J.-C.、Saunders, L. D.、Beck, C. A.、Feasby, T. E.、Ghali, W. A.(2005)。Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data。Medical Care,43(11),1130-1139。  new window
9.Rosenfeld, P.、Russell, D.(2012)。A review of factors influencing utilization of home and community-based long-term care: trends and implications to the nursing workforce。Policy Polit Nurs Pract,13,72-80。  new window
10.Kim, T. A.、Gordes, K. L.、Alon, G.(2010)。Utilization of physical therapy in home health care under the prospective payment system。J Geriatr Phys Ther,33,2-9。  new window
11.Riggs, J. S.、Madigan, E. A.、Fortinsky, R. H.(2011)。Home health care nursing visit intensity and heart failure patient outcomes。Home Health Care Manag Pract,23,412-420。  new window
12.Tsauo, J. Y.、Leu, W. S.、Chen, Y. T.、Yang, R. S.(2005)。Effects on function and quality of life of postoperative home-based physical therapy for patients with hip fracture。Arch Phys Med Rehabil,86,1953-1957。  new window
13.洪麗珍、郭憲文(20011200)。Effectiveness of Family Care Intervention Program on Activity of Daily Living among Disabled Patients。The Journal of Nursing Research,9(5),191-202。new window  new window
14.Lin, C. J.、Meit, M.(2005)。Changes in medicare home health care use and practices in rural communities: 1997 to 2001。J Aging Health,17,351-362。  new window
15.Wu, Y.、McCrone, S. H.、Lai, H. J.(2008)。Health Behaviors and Transitions of Physical Disability Among Community-Dwelling Older Adults。Res Aging,30,572-591。  new window
研究報告
1.行政院經濟建設委員會(2012)。中華民國2012年至2060年人口推計報告。臺北市:行政院經濟建設委員會。  延伸查詢new window
圖書
1.楊志良(2009)。長期照護保險法制組織體制及保險對象之評估。臺北:行政院經濟建設委員會。  延伸查詢new window
2.衛生福利部(2011)。2010年國民長期照護需要調查。台北:衛生福利部。  延伸查詢new window
3.內政部(2000)。中華民國老人狀況調查報告。台北:內政部統計處。  延伸查詢new window
4.內政部(2007)。我國長期照顧十年計畫:大溫暖社會福利套案之旗艦計畫。臺北:內政部。  延伸查詢new window
5.World Health Organization(2001)。International classification of functioning, disability, and health。Geneva:World Health Organization。  new window
其他
1.Clark, R. F.。An introduction to the National Long-TermCare Survey,http://aspe.hhs.gov/daltcp/reports/nltcssu2.pdf, 2015/02/01。  new window
2.衛生福利部。長照保險制度規劃,http://www.mohw.gov.tw/MOHW_Upload/doc/長照保險制度規劃_0044943001.pdf, 2015/03/15。  延伸查詢new window
圖書論文
1.陳美津、藍忠孚(2002)。長期照護復健服務團隊之組成、資格認定與分工。長期照護復健服務模式之探討。苗栗:國家衛生研究院。  延伸查詢new window
 
 
 
 
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