台灣長照機構照護品質初探-以某資料庫大數據為例

ASIA unversity > 醫學暨健康學院 > 健康產業管理學系 > 長期照護組 > 博碩士論文 > Item 310904400/112274

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题名:	台灣長照機構照護品質初探-以某資料庫大數據為例 Explored Study on Quality of Care in Long-Term Care Institutions in Taiwan: An Example of Big Data Analysis
作者:	賴昀宏 Lai, Yun-Hung
贡献者:	健康產業管理學系長期照護組
关键词:	長期照護;長照機構;照護品質 long-term care;long-term care institutions;care quality
日期:	2019
上传时间:	2019-10-28 03:48:00 (UTC+0)
出版者:	亞洲大學
摘要:	目的:人口老化所衍生的長期照護問題已逐漸受到重視，住宿型長照機構之照護品質議題更迫切需要關注。本論文以某住宿型長照資訊管理系統數據庫研擬長照機構照護品質長期監控指標，探討縱貫面及橫斷面觀察下之差異及其風險因子。方法:運用某住宿型長照資訊管理系統數據庫且取得長照機構同意後，由資訊系統公司將機構與住民可辨識個體身份資料轉碼之後再提供給研究者。取得263位2017-2018新入住住民兩年資料。探討ADL/IADL分數、認知功能、體重等指標每季變化、照護品質指標分布情形。所有指標皆以當季所有住民之橫段面與從住民入住開始縱貫面觀察到的數據計算之，以探討兩種計算指標方式何者較能呈現機構照護品質。結果:本研究性別比率相似(男性52.5%)，平均年齡77.2歲、平均入住時間124.4天。品質指標在橫斷面觀察的表現皆沒有呈現明顯趨勢，而在縱貫面觀察下ADL、MMSE分數在第六季之前皆有提升的趨勢，跌倒與非計畫性轉院的比率則是隨著時間有下降的趨勢。結論: 縱貫面觀察能控制因新入住住民資料對指標造成之影響，進而將住民入住受到照護後，所造成各項指標發生之變化直接反映在指標上，長照機構照護品質縱貫面觀察可能比橫斷面觀察更具意義。 Objective: The issue of long-term care owing to an aging population has gradually attracted attention. The care quality of residential long-term care institutions is a problem that requires urgent attention. In the present paper, the residential long-term care information management system database was used to study long-term monitoring markers for long-term care institution care quality and to examine differences under longitudinal and cross-sectional observations and their risk factors. Method: A residential long-term care information management system database was used with consent from long-term care institutions. An information system company provided service for transcoding identifiable personal information of the institutions and residents, and the codes were provided to the researcher. Two years of data of 263 new residents who were enrolled in 2017–2018 were obtained. We examined the quarterly changes in ADL/IADL scores, cognitive function, weight, and other markers, and the distribution status of care quality markers. All indicators are calculated from the cross-section of all residents in the season and the data observed from the inhabitants’ residence. In order to explore the two ways of calculating indicators, it is better to present the quality of institutional care. Result: The sex ratio (male: 52.5%) in this study was approximately equal, mean age was 77.2 years, and the mean length of stay was 124.4 days. No significant trends were noted in quality markers in cross-sectional observations. However, under longitudinal observations, the ADL and MMSE scores increased before the sixth quarter, while falls and the ratio of unplanned hospital transfers decreased over time. Conclusion: The effects of new resident data on markers can be controlled through longitudinal observations, thereby directly reflecting the changes in various markers on the markers after residents were admitted to care institutions. Therefore, longitudinal observations of long-term care institution care quality may be more meaningful than cross-sectional observations.
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