| Summary: | 碩士 === 台北醫學院 === 護理學研究所 === 89 === The purpose of this thesis was to examine the current nursing homes services in Taiwan,and explore the difference between hospital-based and free-standing nursing homes. We investigated all nursing homes in Taiwan. These nursing homes should be opened before March 1990. Totally, we had 115 nursing homes. There were 65 hospital-base nursing homes and 50 free-standing nursing homes. The period of data collections was from Oct 2000 to Nov 2000. All nursing homes would response to our study. The successful rate is 100%. All data were analyzed by using descriptive statistics, chi-square test, t-test and mann-whitney u test.
Several phenomena were presented in the analyzed data:
1. most of hospital-base nursing homes are publicly owned. The education background of nursing leaders were higher, space of each beds were larger and most of them had their own buildings. All of these had significant difference（p<0.001）；Both of them would like to restrict the admission of psychological and problem behavior dementia cases. They would evaluate of each cases individually according to the care requirement, physical-mental condition and family condition. However, the hospital-based nursing home would charge much money than free-standing nursing home with a significant difference（restrict the admission of cases：p<0.001；evaluate：p<0.05；charge：p<0.001）.
2. hospital-based nursing homes would have more nursing staffs. They would work 8 hours everyday with much high paid. Other service staffs, including of physical therapists, social workers, pharmacists, nutritionists….etc, the former would have more these specialists than the latter. All of these have significant difference（human source：p<0.001；salary of nurse specialist: p <0.05；salary of nurse p<0.01）.
3. hospital-based nursing homes would had more elder cases. Besides, most cases of them were transferred from hospital. And most of free-standing nursing homes cases were came from homes. The former would have their own hospital to support them. The latter would ask local hospital to cooperate. It has a significant difference（p<0.001）.
4. hospital-based nursing homes would have much service on medicine and pain-control. They would do the most invasive nursing procedures by nurses，All of these have significant difference（p<0.05）. There are no significant difference on the services of physical therapy, life care and social support.
5. The results of care, hospital-based nursing homes would have more chance to perform immediate care. But they had a high incidence of UTI and mortality rate. all of these are no significant difference.
Our study could offer the references for all authorities, to support those established organizations, for nursing education and staffs training. It is also useful for reference to government introduce policy of “nursing home”. It would enhance the quality of nursing home.
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