[[alternative]]The Approach on Long-Term Care in Potential among the Discharge -Planned Patients--in case of one Regional Hospital in Eastern Taiwan

[[abstract]]醫學的發展是希望人類能更健康長壽，但醫療無法解決所有的健康生活問題，只能提供一定有限度之介入改善；在醫療產生前段階段性之功效緩解將漸屆瓶頸，後續只能轉往『照護(照顧、支持及保護)』等安排來發展。國內之長期照護之發展仍停滯不前。然而，先進國家已經開始往新世紀長期照護之預防保健上發展。 本研究欲探討出院準備服務病人其潛在之長期照護需求風險，採橫斷式、立意取樣，以國內東部某醫療院所40歲以上內外科病人為收案對象，使用日本「介護預防篩檢表｣，及病歷回顧方式取得資料。研究結果顯示，104位出院準備服務個案，平均年齡65.2 ±12.3歲，含潛在長期照護需求風險者高達84位(81%)，其中所含其他次級性風險向度之分佈依序為，整體性潛在長期照護需求之風險向度者有27位(26%)、活動及運動向度31人(30%)、膳食營養向度4人(3.8%)、口牙向度9人(8.7%)、鬱卒或憂鬱13人(12.5%)。以迴歸分析潛在之長期照護風險因子之相關性，顯示個人社經地位指數與潛在長期照護需求風險有顯著相關，低社經地位其潛在長期照護風險是高社經地位的6.3倍，其他者則相關性不顯著。 介護預防篩檢表乃日本在推動長期照護之餘率風氣之先發展者，出能早期偵測孱弱或失能前期之風險，已早進入政策之常態使用，開啟了新三段五級之新世紀預防保健契機。國內長期照護之推動猶在未遇之天，更談不上長期照護之預防保健，而出院準備服務推動多年，仍止於醫療之轉換與個案之掌握，偏離其本應有之個案為中心照護之理想。本研究於國內出院準備服務個案，嘗試引進先進之新思維作長期照護潛在風險之操作，期望能從急性醫療出院對象中早期發現潛在之失能並早期介入。[[abstract]]Hygiene development among humans is focused on being healthier and living longer, but medicine cannot meet all problems solving for the humans but limited intervening relieving. Medical care will be only a phase by the care arrangement, it will be shifted to long-term care(LTC), support & protection then. Even though there be somewhat development of LTC in Taiwan, but slow enough, the progressing of it tend to be preventing campaigns & approaches of the LTC in advanced countries in this 21st century. The study has been planned to explore the LTC risks in potential by cross sectional design based on Kaigo-Yobo Checklist from Japan and health profile reviewing by charts among those arbitrary patients of 104 subjects above 40 under discharge planning in one eastern hospital in Taiwan. The results showed, their mean age was 65.2(±12.3). Upto 84 (81%) participants might be regarded as LTC risk in potential. And among those 84 participants with LTC risks in potential we could divided into several domains with priority, 27 participants (26%) for the domain generalized, 31 participants (30%) for the domain of mobility, 4 participants (3.8%) for the domain of diet and nutrition, 9 participants (8.7%) for the domain of oral and teeth, and 13 participants (12.5%) for the domain of depression. We have analyzed it by logistic regression analysis, mainly revealing the correlation between LTC risks in potential and socioeconomic status(SES), i.e. LTC risks in potential for low SES was 6.3 times higher than the ones with high SES, but not very significantly correlated otherwise. The Japan’s Kaigo-Yobo checklist is a leading screening tool for LTC risks, to early detect the frailty or prediability status. It has always been used as the policy instruments by the government, and to create the new niches of the three-section- five-level framework for preventive health care. The long-term care campaign in Taiwan is still slowly progressive, and rather, far away from the disability or LTC risk prevention.The discharge planning service has been conducted for years in Taiwan, but it, rather than client centered, only focused on the transfering of health care systems with deviation. This study tried to apply the screening tool on the cases of discharge planning service, and we hope to early detect potential pre-disabilities and provide early prevention then