台灣腦中風病人急性後期照護需要之探討

吳 冠穎(Kuan-Ying Wu), 吳 肖琪(Shiao-Chi Wu), Yen-Ni Hung, 吳 君誠(Chun-Chen Wu), 林 麗嬋(Li-Chan Lin), 胡 漢華(Han-Hwa Hu)

Research output: Contribution to journalArticle

Abstract

Objectives: To estimate the need for post-acute care (PAC) and to determine the factors related to that need for stroke patients in Taiwan. Methods: All new cases of stroke reported to the National Health Insurance Database (NHID) in 2005 were identified in this retrospective cohort study. Prolonged hospital stay (PHS, ≥29 days), readmission within 1 to 14 days, and combined PHS with readmission were the proxies for estimating the need for PAC. Multilevel analysis was used to examine the relationships among patients, hospital characteristics, and the need for PAC. Results: Risk markers for the need for PAC in stroke patients included male gender, age over 80, subarachnoid hemorrhage, comorbidity, index hospitalization in a division of rehabilitation medicine, and strokes related to surgery. Stroke patients hospitalized in medical centers were more likely to receive PHS while those hospitalized in district hospitals were more likely to be readmitted. Stoke patients with a prolonged hospital stay or readmission within 14 days were used as indicators to estimate the need for PAC; these accounted for 10.11-23.13% of stroke patients. PAC days accounted for 16.94-44.68% of the total length of stay. The hospital days per stroke patient may be reduced by 2.06-8.17 days, and hospital bed occupancy may be reduced by 306-1,210 beds after implementation of PAC. Conclusions: As many as 10.11-23.13% of stroke patients may need PAC. PAC payment/reimbursement policy may be considered in order to reduce acute medical expenditures.
Original languageTraditional Chinese
Pages (from-to)251-262
Number of pages12
JournalTaiwan Journal of Public Health
Volume31
Issue number3
DOIs
Publication statusPublished - 2012

Cite this

吳冠穎(Kuan-Ying W, 吳肖琪(Shiao-Chi W, Hung, Y-N., 吳君誠(Chun-Chen W, 林麗嬋(Li-Chan L, & 胡漢華(Han-Hwa H (2012). 台灣腦中風病人急性後期照護需要之探討. Taiwan Journal of Public Health, 31(3), 251-262. https://doi.org/10.6288/TJPH2012-31-03-05