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題 名 | 結合LACE、8P工具及醫院整合醫學專科醫師介入創新制度降低出院後30日內再住院率及照護費用:以某醫學中心為例=Reducing the 30-day Readmission Rates and Healthcare Expenditure through an Innovation Model of Integrating Hospitalist, LACE Index and 8P Screening Tool in a Tertiary Hospital in Taiwan |
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作 者 | 吳盈瑩; 張政國; 林玲玉; 陳美如; 江季蓉; 孫茂勝; | 書刊名 | 醫務管理期刊 |
卷 期 | 19:2 2018.06[民107.06] |
頁 次 | 頁79-98 |
分類號 | 419.5 |
關鍵詞 | 醫院整合醫學專科醫師; LACE指數; 8P篩選工具; 出院後30日內再住院率; 費用; Hospitalist; LACE index; 8P screening tool; 30-day readmission rate; Expenditure; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:了解醫院整合醫學專科醫師(Hospitalist)結合LACE指數與8P篩選工具之整合照護模式與傳統照護制度之出院後30日內再住院率與住院費用差異。方法:樣本醫院2015年7至12月內科全人整合病房為導入組,胃腸肝膽內科病房為對照組。使用羅吉斯迴歸(Logistic Regression)與複迴歸(Multiple Regression Analysis)比較再住院率及平均住院費用(採Log10計算對數)之差異。結果:本研究共1,476位個案,導入組638名,對照組838名。導入組出院後30日內再住院率(p = 0.018)與平均醫療總花費(p <0.001)皆顯著低於對照組。半數費用類別導入組亦顯著低於對照組。結論:採用Hospitalist、LACE指數與8P篩選之整合照護制度深入評估高再住院風險病人之問題,透過各職類人員協作,在病人住院時早期介入,可有效降低病人再住院率與醫療資源耗用。 |
英文摘要 | Objectives: To validate the difference of 30-day readmission rates and the healthcare expenditures between the innovation model (integrated with the hospitalist, the LACE index and the 8P screening tool) and the conventional care model. Methods: This study employed inpatients from the Holistic Internal Medicine Ward as experimental group and inpatients from the Gastroenterology Ward as control group in the target hospital in Taiwan between July and December 2015. Logistic regression was used to analyze the difference of 30-day readmission rate, and multiple regression analysis was applied for healthcare expenditure (Log10) analyses between these two groups. Results: A total of 1,476 patients (638 as experimental group and 838 as control group) were included in this study. The 30-day readmission (p = 0.018) and the average healthcare expenditure (p < 0.001) in experimental group were significantly lower than those in control group. Half categories of the healthcare expenditures in experimental group were also significantly lower than those in control group. Conclusions: Integrated healthcare model may reduce 30-day readmission rates and costs efficaciously as hospitalists can screen inpatients at high-readmission risks by LACE index, and initiate early intervention as well as interdisciplinary communication channels. |
本系統中英文摘要資訊取自各篇刊載內容。