| Summary: | 碩士 === 國立臺灣大學 === 健康政策與管理研究所 === 102 === Background: Population aging has been widely discussed in Taiwan. As such policy for caring older adults developing, there are two authorities conducting long-term care (LTC) services to those who are eligible for disability,which are 10-year plan for LTC programs and regulations on the permission and administration of the employment of foreign workers. The standards and assessments for eligible rules between these two authorities are quite different. In the requirement of 10-year plan for LTC programs, the eligible criteria are based on 6-item functions assessments, whereas the requirement in regulations on the permission and administration of the employment foreign workers are based on Barthel Index.
Purpose: The purpose of this study is to compare the context and scoring rules between 6-item functions assessment and Barthel Index.We used advanced statistic method to identify scoring rules and outcome measurements between these two assessments.
Method: Samples are collected by approaching transferring cases via the southern branch of LTC management center in Taipei City and people who lived in LTC facilities in Taipei City or New Taipei City. The inclusion criteria are those who apply for LTC services. 100 cases are included in this study. Spearman''s rank correlation and Wilcoxon sign rank test are used in comparing 6-item functions assessments and Barthel Index.
Result: Results indicated the reliability and validity of both 6-items functions assessment and Barthel Index were Acceptable(Cronbach’s α＞0.7;Confirmatory Factor Analysis results: Barthel Index：χ2/ df =4.287、RMSEA =0.181、CFI =0.951; 6-items functions assessment：χ2/ df =2.26、RMSEA =0.112、CFI =0.981). The 6-items functions assessment and Barthel Index had a significant correlation and Spearman''s rank correlation coefficient was 0.931(p <0.05). The correlation coefficient of 6-items functions assessment and Barthel Index of people who evaluated non-disable level by Barthel Index was 1.000(p < 0.05). The correlation coefficient of 6-items functions assessment and Barthel Index of people who evaluated low-disable level by Barthel Index was 0.453(p >0.05). The correlation coefficient of 6-items functions assessment and Barthel Index of people who evaluated mid-disable level by Barthel Index was 0.290(p >0.05). The correlation coefficient of 6-items functions assessment and Barthel Index of people who evaluated high-disable level by Barthel Index was 0.827(p <0.05). For the whole population, the result of Wilcoxon sign rank test between 6-items functions assessment and Barthel Index was significant(p <0.05), indicating 6-items functions assessment tended to underestimate the disability level in comparing to Barthel index. For non-disabled poeple, the result of Wilcoxon sign rank test was non-significant(p >0.05), indicating 6-items functions assessment tended to overestimate the disability level in comparing to Barthel index. For low-disabled people, The result of Wilcoxon sign rank test was non-significant(p >0.05), indicating 6-items functions assessment tended to overestimate the disability level in comparing to Barthel index.For mid-disabled people ,The result of Wilcoxon sign rank test was non-significant(p >0.05), indicating 6-items functions assessment tended to overestimate the disability level in comparing to Barthel index. For high-disabled people, the result of Wilcoxon sign rank test was significant(p <0.05), indicating 6-items functions assessment tended to underestimate the disability level in comparing to Barthel index.
Conclusions and recommendations:
Scoring ranking between 6-item functions assessments and Barthel Index were significantly different in those who were servely disabled. Poeple who evaluted as severely disabled by Barthel Index were tended to be evaluated as moderately diabled by 6-item functions assessment. This result might be due to the sensitivity of specific questions in Barthel Index are aiming for detecting early stage disabilities, such as climbing stairs, which were not included in 6-item functions assessment. As Taiwan enters the aged society in the next 5 years, it is important to futher investigate the tools used for evaluating long-term care needs in Taiwan and develop a single tool is strongly recommended.
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