| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 105 === The increasing number of people with dementia is one of the most challenging problems for the worldwide healthcare system . In Taiwan , the estimation of prevalence of dementia will increase to 4.65% of the population , approximately 8.5 million people will suffer from dementia in 2061. Because dementia becomes the mainly causation of disability of elders , the World Health Organization lists dementia as a crucial issue of public health problem.
Current evidence-based guidelines for the treatment of dementia recommend a wide variety of medication and non-pharmacological treatment options . However there are no pharmacological treatments demonstrated to cure the dementia and there are no any preventive strategies either. Rehabilitation is an important non-pharmacological treatment options for dementia. Rehabilitation combines multiple therapies including physiotherapy , occupational therapy , psychological therapy and speech therapy .Moreover in Taiwan , the expense of rehabilitation therapies is covered by the NHI program and over 99% of people are enrolled in the NHI program.
In the total of 5,129 patients are diagnosed with dementia between 2005 and 2010 . 66.5% of patients received the rehabilitation therapies .the proportion of patients was the highest (97.5%) centered on psychic-related rehabilitation (97.5%) , comparing to other intervention is a huge gap . Both patients and the medical providers’ characteristics were investigated to determine their influence on rehabilitation receipt. including “ patient’s gender” ,“ past admission ” , “OPD visits in the last year” , “ provider’s specialty “ , “provider’s gender ”, “provider’s age ” , “accreditation level “ , “ past year of patient volume” , which significantly affect patient’s decision of receiving rehabilitation or not .
Although 66.5% dementia patients receive rehabilitation therapy , they only take single therapy rather than multidisciplinary treatment. The results of this study also suggest that patient’s health status is an important factor influencing patient to receive rehabilitation therapy . Medical provider is also an important role for the patients to receive rehabilitation services . In the future , health care system should improve access of mobile rehabilitation in communities . and should provide full information of dementia disease , and the related welfare policy for the patients during diagnostic stage .
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