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Patient Perceived Importance and Need for Care Coordination
Patient perspectives,Care coordination,Fragmentation of care,Health behavior model,
|Publication Year :||2020|
研究結果： 民眾對照護協調性的重視程度高(平均17.01分，滿分20)，曾接受過片段式照護的有37.79%，需要醫療人員協助整合醫療服務的有43.81%。多元線性迴歸與多元羅吉斯迴歸分析發現，年齡(70-79歲估計值=-0.46, P=0.0421)、80歲以上估計值=-1.31,P<0.0001)、家庭所得5萬以上(估計值=1.18,P=0.0306)與病患對於照護協調重要性有顯著相關，而需要醫療人員協助整合其照護服務與否，在個人因素中年齡(70-79歲Odds Ratio OR=0.67、P=0.0017)、教育程度(大專以上OR=1.50、P=0.0126)達統計上顯著相關。
Background：Taiwanese people enjoy a high degree of freedom of choice when seeing a doctor. In the highly specialized health care system, fragmentation of care exists in ambulatory care settings. The Ministry of Health and Welfare and local governments have implemented integrated care plans for many years, yet, no evidence has shown the effectiveness of such plans. In addition, there has been no relevant research examining the perceived importance and needs for care coordination from patient perspectives.
Objectives：This study aims to explore patient perceived importance of care coordination, their experience in receiving fragmented care, and the needs of a care coordinator as well as associated factors.
Methods：This research project was conducted at the Health Service Center in Xinyi District, Taipei City. Based on the students’ participation in the public services at the Health Service Center, the students were instructed to analyze the data of 'Patient Health Care Experience Survey,” which inquired the patients’ experience and opinion about care coordination. The subjects included in the survey were those who reached 60 years old or above and had at least one visit to the doctor in the past 12 months (N=2144).
Results：The average score of the perceived importance of care coordination was 17.01 out of 20. About 37.79% of the respondents experienced fragmented care, and 43.81% of the respondents expressed the need for a care coordinator. Results from the multiple linear regression and multiple logistic regression respectively showed that, older people had lower scores of importance of care coordination (70-79 years old β= -0.46, p=0.0421 ; 80 years old or older β= -1.31, p<0.0001) and people with higher income showed higher scores (β=0.76, p=0.0184). Concerning the need for a care coordination, older people expressed lower need (70-79 years old OR=0.67, p=0.0017) yet people with higher education (college degree or above OR=1.50, p=0.0126) showed higher need for a care coordinator.
Conclusion：This study showed that older people considered that care coordination to be less important and lower need for care coordination. On the other hand, people with higher income and higher education showed higher perceived importance and higher need for care coordination services. When serving in the community, public health nurses should pay attention to these personal characteristics and increase the needed services to reduce fragmented ambulatory care.
|Appears in Collections:||公共衛生碩士學位學程|
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