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| 題 名 | 建置高效能社區照護體系以照顧有複雜性需求之病人與家屬=Establishment of a High-Performing Community Care System for Patients and Family in Complex Needs |
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| 作 者 | 李易翰; 施至遠; 徐愫萱; 孫文榮; 翁瑞萱; 吳孟嬪; 黃喬煜; 張凱評; 白裕民; 劉嘉仁; 黃勝堅; | 書刊名 | 北市醫學雜誌 |
| 卷 期 | 15:1 2018.03[民107.03] |
| 頁 次 | 頁1-12 |
| 分類號 | 419.71 |
| 關鍵詞 | 高效能照護; 複雜性需求; 整合性照護; 居家醫療照護; 居家安寧醫療; High-performing care system; Complex needs; Integrated care; Home medical care; Home palliative care; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 高齡化社會中,複雜性需求在高齡長者中越來越常見。如何因應複雜性需求建立高效能的照護系統是當務之急。高效能照護系統應具備有高度整合、單一窗口、周全照顧、橫跨醫療與社會照護的特性。臺北市立聯合醫院於蘭州國宅建立的整合照護計畫「家庭為中心的整合照護計畫」以具備居家安寧照護能力的醫療團隊及個案管理制度為核心。我們承諾「從生到死」的周全照護。整合社政、衛政、民政及非政府組織的能量,提供多項即時服務。提供每個家庭更好的支持系統,讓長者能安心在社區健康老化。蘭州國宅的「家庭為中心的整合照護計畫」具備有高度整合性、主動出擊、促進溝通、共享決策、支持全家庭、及領導改變文化的特色。透過分享北市聯醫推動「蘭州國宅」的經驗,期待建立起我國獨有的高效能社區照護模型。 |
| 英文摘要 | Complex needs among elderly are common in an aging society. There is an obvious and immediate need to build a high-performance care system to meet these requirements. A high-performance care system should have characters of highly integrated, single windowed, comprehensive care, and integrating medical and social care. Home-based health care team with home-based palliative care ability and case management system are the core elements of the "Home-Centered Integrated-Care Program", which is built by the Taipei City Hospital in Lan Zhou Public Housing Community. We commit the care from womb to tomb. We have integrated the health care system, social welfare system, civil affair system, and non-government organizations to provide all kinds of supports promptly. This program provides a better support for the whole family and allows the elder people to age healthily in the community. The “Home-Centered Integrated-Care Program” in Lan Zhou Public Housing Community is featured with its high coordination, active action, communication promotion, share decision-making, supporting family, and leadership in changing culture. Through "Lan Zhou Experience" of the Taipei City Hospital, we hope to shape the model of high-performance care system in the community in our country. |
本系統中英文摘要資訊取自各篇刊載內容。