頁籤選單縮合
題 名 | 臺北榮民總醫院大德病房五年住院病患分析=A Five-Year Analysis of the Inpatient Service of the Hospice and Palliative Care Unit in VGH-Taipei |
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作 者 | 邱金德; 陳健文; 林明慧; 吳彬源; 劉瑞瑤; 陳曾基; 陳振文; 黃信彰; 蔡世滋; | 書刊名 | 臺灣家庭醫學雜誌 |
卷 期 | 15:3 民94.09 |
頁 次 | 頁123-133 |
分類號 | 419.77 |
關鍵詞 | 安寧療護科病房; 大德病房; Inpatient hospice care; Palliative care; |
語 文 | 中文(Chinese) |
中文摘要 | 臺北榮民總醫院自1997年7月起設置安寧療護科病房(大德病房),至2002年7月底止,總住院病患共1,533人次。本研究統整分析電腦資料庫5年來的病患資料,並比較全民健康保險安寧療護整合性照護試辦計畫(試辦計畫)前後之異同。住院病患多數為男性(65.6%),平均年齡67.4歲(標準差13.9),來源多為院內轉介(58.1%),常見診斷為肺癌、大腸直腸癌、胃癌等,平均住院16.1(±15.2)日。出院原因為死亡者平均住院14.2日(±14.6),穩定出院及其他為21.9日(±15.5),兩者顯著差異(p<0.001)。死亡病患接受安寧療護期間於7日內者(晚期轉介)佔38%。罹病期平均為22.4月,較長者:乳癌、子宮頸癌、攝護腺癌;較短者:胰臟癌、膽道癌、食道癌。住院期較長者:攝護腺癌、子宮頸癌、肺癌;較短者:咽喉癌、血液淋巴腫瘤、卵巢癌。榮民醫院特性影響年齡性別分布,但榮民身分不影響住院日數。試辦計畫後,住院日數由17.5(±16.4)減少為14.5(±13.5)日(p<0.001),主因為29日以上者減少而7日內(尤其3日內)者增加。長期滯床問題得到積極的解決,週轉率上升,更多瀕死病患住進大德病房,接受妥善照顧。本研究未包括症狀及治療部分,但以高比例的晚期轉介可知,推廣安寧療護,仍要繼續努力。 |
英文摘要 | Since the establishment of the Dah-Der hospice palliative unit in the Veterans General Hospital-Taipei in July 1997, a total of 1,533 admissions were recorded with a computerized database until July 2002. We analyzed the data and compared the before and after implementaion of the “pilot project on Per-diem payment for inpatient hospice services of Taiwan's National Health Insurance program” (PDP) to see if there were any differences. The results: the patients were mostly male (65.6%), with a mean of 67.4 years old (standard error 13.9, SE). The source of the patients was mostly referred from within the hospital (58.1%). The most common diagnoses were lung cancer, colon-rectal cancer, and gastric cancer. The average duration of the inpatient service time is 16.1 (±15.2, ±SD) days. Those patients discharged due to death or dying had an average duration of 14.2 (±14.6) days, whereas others discharged under stable condition had 21.9 (±15.5) days; there was a statistically significant difference between these two groups. 38% of known expired patients had received hospice palliative care for less than 7 days (late referral). After the implementation of the PDP, the average duration of hospital stay decreased from 17.5 (±16.4) to 14.5 (±13.5) days (P<0.001). This increased the turn-over rate of the beds, and allowed the dying patients to be admitted to the Dah-Der ward. This means more families can have the opportunity of receiving holistic care and proper bereavement support. |
本系統中英文摘要資訊取自各篇刊載內容。