Objective: Chronic ward is the intermediate extended care from the acute care. When the patient still need some medical or rehabilitation care . So he is transfer to chronic ward for lower cost and faster bed rotation , family doctor care the acute bed or terminal ward at some medical center or regional hospital now. If the chronic ward could be cared by the family doctor from concerning medical cost and holistic quality. The quality control and medical resources effect, organization modification of the chronic ward cared by family physicians needs our study for further opinion.
Method: From 2007/10/01 to 2008/01/31, part 1: Qualitative method is used to study the process and structure of the chronic ward by depth-talking skill with the ward staff. Part2: Quantitative method is used to study the outcome of the chronic ward by study of the basic and quality index of the chronic ward and the patient. Such as physical and psychological state of the patient and medical resources used before and after the ward. Results: qualitative analysis shows: 1.total care in long term care is the advantage of family practice 2.organization modification is necessary for family practice in chronic ward 3.patient safety medical adverse events show low prevalence and good prevention in chronic ward 4. good cooperation mechanism between physicians and nurse is necessary 5.good satisfaction among patient and medical staff is also needed. From the study , cerebral vascular accident(CVA) and neurological traumas are the main admission reason(73.9%) ,monthly ward infection rate is 5%, it is better than traditional chronic ward(10.8%). Chronic ward has less medical management. So diagnosis fee, ward fee, drug fee,total charge is lower than acute ward. Physical and psychological state after first month and second month in the chronic ward improved significantly.
Discussion: Monthly bed sore rate and constraint rate is noted as 2.5 % and 4.3%. So good infection control prevent more transfer to acute ward, strengthening the recognition of proper constraint and prevention of bed sore make higher quality and lower adverse events.
KEY WORD:physical life score, psychosocial score, chronic ward, intermediate extended care, medical resources effect, quality index of the chronic ward
