臺灣博碩士論文加值系統

日間照護服務是正在發展中的一種社區式長期照護模式，其透過個人化的照護計劃來滿足失能病人的需求，有關老人利用日間照護服務情形，已逐漸獲致決策者及學界的重視。
本研究為橫斷式研究，研究資料係取自耕莘醫院日間照護中心，於1994年7月初至1999年3月底入住的病人及其主要照護者。本研究目的旨在瞭解日間照護病人利用服務情形及探討影響病人利用日間照護服務之影響因素。此外，希望藉由本研究以建立病人留院日數的預測模式，並提供日間照護中心預測病人離院日期及增進醫療資源利用。
本研究的重要發現歸納如下：(1)大部份病人的總留院日數有偏低的情形( 25.4％的病人≦14天)，且未合乎經濟效益；(2)日間照護病人再利用服務的比率偏低( 18.5％ )；(3)日間照護中心入住的新個案人數逐年減少，個案流動性有降低的現象；(4)不論經過何種分析，在控制其他重要變項下，病人的需要因素仍是影響及預測病人利用日間照護服務的主要因素。

Adult day care ( ADC ) is the developing model for community-base long-term care designed to meet the needs of functionally impaired elderly through an individualized plan of care. At the present day, many policy makers and researchers increasingly concerned with the utilization of ADC service by the elderly. This was a cross-section study. The data collected from the Adult Day Care Center of Cardinal Tien Hospital. The subjects admitted in July 1994 to March 1999. The purposes of this study were to understand the utilization of services for ADC patients and to explore the factors that influenced ADC patients to use the services. In addition, we hoped to construct a model through this study to supply ADC center for predicting the date of discharge and improving utilization of medical resources. The important findings of this study are summarized as follows： (1) The most patients'' total length of stay were low ( 25.4％ of patients ≦14 days ) and not to conform to the economic benefits. (2) The rate of re-using ADC service for ADC patients was low ( 18.5％ ). (3) The number of new admissions of ADC center deceased year after year, and the turnover rate of patients tended to decease. (4) The need factors remained the important predictors when we control the other variables.

第一章 緒論…………………………………………………1
第一節 前言…………………………………………………1
第二節 研究目的………………………………………………4
第二章 文獻探討……………………………………………………5
第一節 日間照護服務…………………………………………5
第二節 日間照護中心病人及其主要照護者之
基本資料及病人留院日數……………………18
第三節 影響日間照護病人利用日間照護服務
之因素……………………………………………24
第三章 研究方法…………………………………………………34
第一節 研究架構與研究假設……………………………34
第二節 研究變項的操作型定義與測量……………37
第三節 研究材料……………………………………………52
第四節 資料分析方法………………………………………56
第四章 研究結果…………………………………………………60
第一節 病人與主要照護者的基本資料
描述……………………………………………60
第二節 病人進入及退出日間照護中心
原因………………………………………75
第三節 病人及其主要照護者對於
日間照護服務的期望………………………78
第四節 病人入住日間照護中心的決定權……… 80
第五節 日間照護病人的服務利用情形…………82
第六節 日間照護病人之總留院日數與病人
及主要照護者之各變項間的關係………87
第七節 日間照護病人總留院日數之
預測因素……………………………………95
第八節 日間照護病人總留院日數之
影響因素……………………………………105
第九節 日間照護病人之再利用服務情形
與病人及主要照護者之各變項間
的關係………………………………………108
第十節 日間照護病人再利用服務情形
之影響因素…………………………………116
第五章 討論………………………………………………118
第一節 病人進入及退出日間照護中心
的原因……………………………………118
第二節 病人及其主要照護者對於
日間照護服務的期望……………………120
第三節 病人入住日間照護中心
的決定權…………………………………… 121
第四節 日間照護病人的服務
利用情形……………………………………122
第五節 病人利用日間照護服務之
影響因素……………………………………125
第六節 研究限制…………………………………138
第六章 結論與建議………………………………………140
第一節 結論…………………………………………140
第二節 建議…………………………………………144
第七章 參考文獻…………………………………………148

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