The development of the case-mix index for screening cerebrovascular disorder's and intractable disease'spatients requiring home health nursing care

脑血管病及疑难杂症居家护理患者筛查病例组合指数的建立

• 批准号: 09672432
• 负责人: ITO Keiichi
• 金额: $ 0.45万
• 依托单位: Tokyo Women's Medical University (1998)Tokyo Women's Medical College, Junior College Nursing (1997)
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09672432/
• 关键词: Case-Mix Index; ADL; care needs; CVD; Neuro-Intractable Disease; Home care; 看護必要度; ADL; 難病

The purpose of this study is to develop the case-mix index for screening cerebrovascular disorders and intractable diseases patients who require home care. The participants of this study were 411 home health patients aged 20 and over, discharged from brain surgery or neurological medicine department at the university hospital.In the study, a hierarchic ordering among physical activities of daily living (ADL) was measured and the association between home health care costs and physical disability levels of the patients was assessed. Actual time needed home health care was converted into "proxy costs" and used in the analysis.Main results were summarized as follows.1) Items of physical ADL constituted a Guttman scale and indicated hierarchically one-dimensional pattern.2) The order of activities from most to least difficult to perform unaided is : dressing, bathing, transfer, communication, continence and feeding.3) Case-mix index exponentially increased with the seriousness of the physical disability levels based on Guttman scale pattern.4) The value of case-mix index to the patients with neuro-intractable diseases was higher than those with cerebrovascular disorders.5) Case-mix index developed on this study was available as one of the index for assessing the relative requirement of receiving home health nursing care.

本研究的目的是开发病例组合指数，用于筛查需要家庭护理的脑血管疾病和疑难杂症患者。这项研究的参与者是 411 名 20 岁及以上的家庭健康患者，他们是从大学医院的脑外科或神经内科出院的。在这项研究中，测量了日常生活体力活动 (ADL) 之间的层次顺序，以及与评估了患者的家庭保健费用和身体残疾程度。将实际需要的家庭医疗保健时间转换为“代理成本”并用于分析。主要结果总结如下。1）身体ADL的项目构成了格特曼量表，并以分层的一维模式表示。2）活动的顺序独立执行从最困难到最不困难的是：穿衣、洗澡、转移、沟通、节制和喂养。3) 根据格特曼量表模式，病例组合指数随着身体残疾水平的严重程度呈指数增加。4)病例组合指数对神经疑难性疾病患者的价值高于脑血管疾病患者。 5)本研究制定的病例组合指数可作为评估家庭健康护理相对需求的指标之一关心。