Exploring Related Factors for Establishment of Respiratory Care Wards in Hospitals

• Main Authors: Chang, Chao-Ching, 張照琴
• Other Authors: Hsu, Yi-Hsin Ph.D.
• Format: Others
• Language: zh-TW
• Published: 2003
• Online Access: http://ndltd.ncl.edu.tw/handle/17036564326322023815

碩士 === 臺北醫學大學 === 醫務管理學系 === 91 === Forty to fifty percent of ICU resources is used on caring ventilator dependent patients (VD patients). The number of patients who need long-term respiratory care due to respiratory failure is increasing yearly, and it has caused remarkable impacts on families, society, and the distribution of health care resources. Transferring VD patients from ICU to Respiratory Care Wards (RCWs) can both increase the quality of care and decrease the cost. This study aims at understanding the current state of RCWs, the related factors of hospitals’ understanding toward the Ventilator Dependents Managed Care Demonstration with Integrated Delivery System & Prospective Payment System (IDS project), and the related factors in setting up RCWs. Surveyed acute hospitals in Taiwan, and questionnaires by mail. One hundred and ninety-five responses were collected, which the response rate 44%. The results indicated that the main difficulties in running RCWs are the source of patients and the recruitment of specialists. Currently, RCW patients were mainly transferred from ICUs of hospitals. There are 45.6% of hospitals have RCW, and 71.3% of hospitals are going to RCW in the near future. The total bed number might increase at least 50% in two years. There are several factors related to hospitals’ understanding toward the IDS project, including the accreditation level, the total beds of the hospital, the occupancy rates of the acute care unit and the ICU, if joining horizontal integration, and the availability of internist, pulmonary physicians, and respiratory therapists. Several factors related to hospitals RCW, including understanding toward the IDS project, the occupancy rate of the acute care unit, and the availability of internist, pulmonary physicians, and respiratory therapists. The factors related to hospitals RCW or in the near future include, i.e., the accreditation level, the above. A hospitals toward the IDS project, and the private hospitals are more likely to establish RCWs. Hospitals having better understanding toward the IDS project, hospitals with less than 100 beds, and hospitals with respiratory therapists are more likely to establish RCWs in the future. The understanding toward the IDS project, the 61-80% occupancy rate of the acute care unit, the number of pulmonary physician, and respiratory therapist are the predictive factors of the number of RCW beds at the present and in the future. The R2 is 24.7% and 30.8%, respectively. According to the results, suggest that the government need to provide local hospital more assistance to help them play a better role in the continuous of care. In order to avoid the crisis of adverse selection and cream skimming of patients, the assessment of RCW care quality and balancing the demand and supply of VD care are urgently needed.