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

为了提供最合适的卫生服务并提供合理的报销系统，我们试图建立长期患者的分类，以适当地反映其临床状况和日常生活活动中的护理和帮助需求（ADL）。这样的分类应基于患者在机构逗留期间相对轻松获得的信息。在目前的调查中，我们进行了一项调查，以评估三个因素的护理和援助量：1）患者的临床状况和援助需求； 2）护士和ADL助手的主观评估； 3）实际花费在护理和援助上的时间。这些受试者由十个医疗机构中的总共891名患者组成：两个特殊疗养院中的203名患者；六个护士住宅中有322人；在一家老年医院的一家医院中有268； 98在一家慢性医院中。首先，进行了……更主观评估的燃烧感作为目标变量，进行了差异分析，根据患者对ADL援助的需求产生了五种类别。接下来，将患者的思想表达作为分析引入了另一个变异。这导致了针对ADL的六个类别的分类。这些类别占护士在工作中感觉到的烧伤感的50％。慢性医院的差异问责制特别低，表明其他因素参与了诱发员工的燃烧感。随着患者的残疾程度的类别，提供护理和援助的时间加长了。我们目前根据需要护理和ADL援助的长期患者的分类似乎足够可靠。根据对医疗服务的需求进行类似的患者分类对于提供合理的报销系统很有用。较少的