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研究生(外文):Shu-yen Huang
論文名稱(外文):The environmental and structural influences on rehabilitation performances of Different Rehabilitative Service models
指導教授(外文):Shu-Chuan Jennifer Yeh
外文關鍵詞:Cost-effectiveness AnalysisRehabilitation model
  • 被引用被引用:2
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Study objectives and significance
Generally, patients go to hospitals or clinical offices for seeking health care service. However, some studies reveal that old patient or those who have disability would get hurt and expose in some dangerous situation, such as falls and infection. As the reasons, the rehabilitation delivery model, which sends the service to patients’ community, is needed. The community delivering-rehabilitation model that this study focuses on integrates hospital center and retirement home. This study is to compare the community delivering-rehabilitation model and general delivery model that patients go to hospital for rehabilitation service.
Data and methods
In one-year study duration from Nov. 1, 2002 to Oct. 31, 2003, the Barthel Index score from two delivery models were collected every 3 months. On the other hand, patients’ rehabilitation costs were collected once 3 months, too. The study unit is individual unit. Cost-effectiveness analysis (CEA) was used here to be a standard comparing tool. CEA was computed by dividing the cost that patient spent in 3 months into the Barthel Index score which patient improved his functional status. Independent variables include environmental factors and structural factors The Environment factors include rehabilitation delivery model and the patient-therapist ratio. Structural factors include chain-affiliation status, instrumental volume and status. The General Estimating Equation was used here for comparing longitudinal dependent data.
The study reveals that environmental factors and structural factors affect the performance of rehabilitation units. Environmental factors positively affect the rehabilitation effect. Structural factors negatively affect the rehabilitation effect. On the other hand, Environmental factors positively affect the rehabilitation efficiency. Structural factors negatively affect the rehabilitation efficiency.
Conclusion and the project’s relevance to public health
The community delivering-rehabilitation model has better rehabilitation effect, but on the aspect of efficiency, is not as good as general delivery model. However, the community delivering-rehabilitation model has good accessibility to patient. It also concerns patient safety. If the model can improve its efficiency, the promotion of health can be further implied in community delivering-rehabilitation model.
中文摘要 II
Abstract IV
目錄 VI
圖目錄 VII
表目錄 VIII
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的與研究問題 3
第二章 文獻探討 4
第一節 法源依據 4
第二節 環境與結構因素對組織績效之影響 7
第三節 成本效果與影響成本效果的因素 9
第四節 巴氏量表簡介 12
第三章 研究方法 13
第一節 研究架構 13
第二節 研究假設 15
第三節 研究方法 16
第四節 分析方法 20
第四章 研究結果 22
第一節 基本資料分析 22
第二節 復健效果分析 24
第三節 成本分析 34
第四節 成本效果分析 38
第五章 結論與建議 41
第一節 討論 41
第二節 結論與建議 46
第三節 研究限制 47
參考文獻 48
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