頁籤選單縮合
題名 | 中期照護:架構老年健康服務的關鍵=Intermediate Care: The Key to Health Care for Older People |
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作者 | 陳亮恭; 黃信彰; | 書刊名 | 臺灣老年醫學暨老年學雜誌 |
卷期 | 3:1 2008.02[民97.02] |
頁次 | 頁1-11 |
分類號 | 419.76 |
關鍵詞 | 社區; 老人; 中期照護; 亞急性照護; Community; Elderly; Intermediate care; Post-acute care; |
語文 | 中文(Chinese) |
中文摘要 | 隨著人口的快速老化,現行的醫療服務體系面臨絕大挑戰。老年人罹患疾病之後往往需要較長的恢復期以回復其罹病之前的生活功能狀態,也因此衍生出不同於傳統醫療服務模式的照護需求。英國在進入二十一世紀後以國家的力量推動「中期照護」 (Intermediate care),以嶄新的醫療服務模式,整合各種醫療服務資源,以回復老年病患最佳的身體功能及減少非必要的入院與入住機構為目標。中期照護的發展模式非常的廣泛,主要包含迅速反應小組、居家醫院、機構式復健、支持性出院、日間復健、社區醫院等,而社區醫院角色的強化更是發展的一大重點。 英國政府在過去的二十年間大幅減少醫院內老年病患因無法出院的長住病房 (long stay unit),藉由中期照護的架構,整合社區中的衛政與社政對於老人照護的資源,打破英國以往的醫療服務模式,讓急性醫院的老年醫學專科醫師直接與社區照護團隊連結,以周全性老人評估作為擬定治療計畫的主要工具,配合病患的需求整合提供適切的治療,在不超過六週的時間內,回復其日常生活功能。 我國現階段的老人照護體系相當缺乏中期照護的概念,加上即將實施的疾病診斷群的健保給付方式,若未能有充分的中期照謢體系承接後續的照顧,老年人罹患急性病後被迫加速出院的情形勢必成為老人健康照護品質的一大威脅。 |
英文摘要 | Along with population aging, healthcare service system is inevitably confronted with mounting challenges. After experiencing acute illnesses, older patients usually need a longer period of time to regain their prior functional status, and various care needs may emerge during this process. The United Kingdom started to promote “Intermediate Care” in the beginning of 21st century to provide quality health care for older patients in order to reduce unnecessary admissions by a brand new medical service model and integration of various medical service resources. Intermediate care incorporates various models of services, including rapid response team, hospital at home, institutional rehabilitation, early supportive discharge, day rehabilitation and community hospital. Of these service models, community hospitals play an especially important role in intermediate care. The policy of long-term care in England has gone through periodical modifications in the past 20 years, especially in long stay geriatric units. Intermediate care integrates social and health care resources in the communities so as to enhance the quality of eldercare services. Meanwhile, the interface of hospital-based geriatricians and community care team has been established. The ultimate goal of intermediate care is to restore the functional status of elderly patients in a period within 6 weeks through comprehensive geriatric assessment and corresponding health services to provide optimal treatment. The concept of intermediate care, however, is lacking in current eldercare service delivery system in Taiwan. In the absence of an intermediate care system, the upcoming implementation of the DRG-based prospective payment system may impair the quality of elderly health care by forcing elderly patients into inappropriate early discharge. Development of an intermediate care service model is therefore of vital importance to the eldercare system in Taiwan. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。