The Relationship between Nosocomial Infections and Medical Resources Consumption as well as the Prognosis in Long-Term Care Facilities－Example of Veteran Healthcare System Nursing Home

• Main Authors: Pao-Lin Jen, 任寶玲
• Other Authors: 龍紀萱
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/78151886921604972006

碩士 === 中國醫藥大學 === 醫務管理學研究所碩士班 === 95 === ABSTRACT Purposes With the improvement of the public health and educational level, the general people in Taiwan live longer. The long-term care facilities (LTCFs) have been rapidly growing because Taiwan has stepped into the aging society, and the problem of nosocomial infections (NIs) in LTCFs has been becoming more and more important. The purpose of this study was to elucidate important risk factors and define the demographic and clinical of infected residents, to investigate the situation of NIs, medical care, consumption of medical resources and prognosis among infected residents who live in the nursing homes of veterans hospitals (VHs) in Taiwan. These findings may provide reference for related organizations while drafting the policy. Methods The quantitative investigation method was used for analysis and deduction. Data were retrospectively collected from 3 nursing homes of VHs in northern, central and southern Taiwan from January 1 to December 31, 2005. Three hundred and sixty-nine NIs among 214 infected residents (average 1.7±0.8 infections per residents) were investigated. Each patient is then followed up for a three-month period. Results The findings show that, by rank of, duration of hospital stay, admitted into intensive care unit (ICU), emergency room (ER) visit, numbers of invasive devices, and numbers of NIs are positive correlated with insurance claim points for hospitalization. In addition, duration of hospital stay, admitted into ICU, numbers of NIs, and ER visit are positive correlated with higher drug expenditure for hospitalization. Duration of hospital stay, ER visit, numbers of NIs, and admitted into ICU are positive correlated with costs of antibiotics for hospitalization. In general, age, number of invasive devices, ER visit, admitted into ICU and long hospital stay are the major factors related to the medical resource expenditure. After a three-month following period, it is found that ER visit is the major factor related to the death of residents with NIs. Suggestions We suggested that, First, the government should legislate a clearly surveillance criteria for LTCFs with regards to infection control improve the care safety and quality of LTCFs. Second, the VH health system should reevaluate the manpower of infection control personnel, and enhance the quality of nursing records as well as ADLs documentation of their residents. Third, a prospective study regarding the change of ADLs in these aged-residents needs to be in the furtue.