| Summary: | 碩士 === 高雄醫學大學 === 公共衛生學研究所碩士在職專班 === 92 === Study purpose:
With the rapid development of science and technology and the increasing number of advance-aged people, the need of home caregivers and medical expenses are raised. Nevertheless, Taiwan is still scanty of effective result evaluation. Along this line, this research is to compare the factors of different qualities, institutions, and different time of taking over cases that influence the whole system of home caregivers. On the other hand, the survival rate and the death rate of the patients taken care of by family caregivers are discussed here, and so is the use of medical services.
Study methodology:
This study is under the medical service model of Andersen and covers 1,624 new cases taken over of Health Insurance in 2001. The timing data of this study are the medical records of the first two years of these new cases. The data management, description, and analysis are with the help of SPSS 10.0 for windows.
Study result:
(1) Taiwan is with higher restriction in hiring a home caregiver than Japan and the United States. The cases (75.5 years old) are older than the average. Their abilities to perform daily behaviors are severely limited (75% of the patients can not move at all). 37.9% of the cases died in the first year and 61.3% died in the second year. (2) Different resources of the cases and different institutions cause different medical service choices and different options of home caregivers. (3) The time of taking over the patient influences the medical expenses. The cases taken over for two years make more use of outpatient services, but they have lower expenses of hospitalization, lower total medical expenses, and less days of hospitalization. (4) The average expenses of hospitalization and total medical in the year before death are higher than that of the surveyors. (5) Factors of age, diagnosis, tubes, institutions, time of taking over cases, and survival rate are considered in the use of medical resources. The use of medical resources explains the 73.6% of coefficient of variations. The use of medical treatment explains the 25.4 % of coefficient of variations. Hospitalization explains the 10.3% of coefficient of variations. Total medical services explain the 15% of coefficient of variations.
Discussion and suggestions:
The study appeals that the whole expenses and days of hospitalization decrease with the help of home caregivers. The average time of taking care of the cases is 10.9 months. The study result suggests that, to meet the practice need, the time of home care services be prolonged for 6 to 10 months more. The expenses of home care diagnosis from a private institution are higher than that from a hospital. Nevertheless, The use of medical services in a hospital is higher than that in a private institution. The study suggests that the relevance among the factors of private institutions and medical expenses be further studied.
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