A REIMBURSEMENT SYSTEM PROPORTIONATE TO THE AMOUNT OF NURSING CARE AND ASSISTANCE RENDERED FOR LONG-TERM PATIENTS

与长期患者护理和援助金额成比例的报销制度

基本信息

批准号：
06454605
负责人：
UMESATO Yoshimasa
金额：
$ 3.46万
依托单位：
NIHON UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1994
资助国家：
日本
起止时间：
1994 至 1995
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-06454605/
关键词：
long-term care patient categories ADL assistance insurance ADL hospitals for the aged nursing homes special nursing homes 在宅療養

项目摘要

In order to offer the most suitable health service and provide a reasonable a reimbursement system, we attempted to establish a classification of long-term patients that would appropriately reflect their clinical conditions and needs for care and assistance in daily life activities (ADL). Such a classification should be based on the patients' information such as can be obtained with relative ease during their stay in institutions.In our present investigation, we conducted a survey to evaluate the amounts of nursing care and assistance in terms of three factors : 1) patients' clinical conditions and needs for assistance ; 2) subjective evaluation by nurses and ADL assistants of their sense of burden ; 3) the actual time spent for nursing care and assistance. The subjects consisted of a total of 891 patients in ten health care institutions : 203 patients in two special nursing homes ; 322 in six nursing homes ; 268 in one hospital for the aged ; 98 in one chronic hospital.First, with the … More subjectively evaluated sense of burden as the target variable, a variance analysis was carried out, which yielded five categories according to the patient's needs for ADL assistance. Next, the patient's expression of ideas was introduced as another variabale into the analysis. This led to a classification with six categories for ADL.These categories accounted for 50% of the variance for the sense of burden felt by nursing personnel in their work. The accountability of the variance was particularly low for the chronic hospital, indicating the involvement of other factors in inducing the sense of burden among the staff. The time to provide care and assistance lengthened as the categorized degree of patient's disability advanced. Our present classification of long-term patients based on the need for care and ADL assistance appeared to be sufficiently reliable. A similar classification of patients according to the need for medical care is useful for providing a reasonable reimbursement system. Less

为了提供卫生服务并提供报销系统，可以适当地反映出他们的临床状况和日常生活中的护理和援助的患者（ADL）。我们在其逗留机构中相对轻松。或目前的NVESTIGTION，我们进行了一项调查，以评估有关因素的护理和援助的数量：1）患者的临床条件和援助需求； 2）护士和ADL的主观评估；他们为护理和援助所花费的时间的帮助。目标变量，进行方差分析，根据ADL援助的patieds jield五个类别。在差异中，护理人员在慢性差异中感受到了50％的负担差异，这表明其他因素参与了引起员工的负担，以提供随着护理和援助的时间而延长。患者的类别是我们的长期护理助理的媒体化，似乎足够可靠