| Summary: | 碩士 === 國立雲林科技大學 === 企業管理系 === 103 === “Readmission Rate within Fourteenth Day” is one of the indexes of evaluating hospital's service quality. Due to the expansion of the health insurance’s expenditure, the paying methods include paying by piece, case payment, global budget payment, paying for performance, diagnosis related groups(DRGs) paying system and capitation payment scheme. All the above methods are under the main policy of saving the expenditure of health insurance.
Therefore, in order to control the expenditure, the hospitals transform their control over the readmission rate from passive monitoring to active monitoring. The subjects of the research are people in the hospitals whose ages are over 65 living in rural area. The research method is collecting the cases of readmission within fourteen days after being discharged from hospital during the year of 2013 from Jan. to Dec, sieving who are over 65 out and excluding the category of the hospitalization being nursing home. The total amount is 500 cases and besides, tracing their clinical data. Evaluation and analysis of the data will explain characteristics of the sample group and the centralizing trends. Besides, analyze different characteristics (like the patients’ characteristic, department, disease and etc.) and the correlation between different characteristics of patients and readmission. Use the above results to infer the relation between each factor and readmission of the same disease, and the regression analysis of each factor.
The results show the five variables, tested by chi-squared test, influence twice hospitalization resulted from the same disease, which are “whether paying by piece ( p＜0.01) ”, “ whether living alone ( p＜0.01) ”, “the source of hospitalization ( p＜0.05) ”, “the main diagnosis ( p＜0.001) ”, and “the way of hospitalization ( p＜0.05)”. The blood urea nitrogen and the creatinine are related to twice hospitalization resulted from the same disease ( p＜0.05). Suggestion: Living alone is a strongly dangerous factor which results in aged patients lived in rural area readmitting to the hospital. It seems that there is high correlation between readmission of high ages living in rural area and social supports. The combination of nurse practitioners, hospital-discharging staffs and home health nursing department can provide the aged patients lived in rural area with more post-services in order to control the readmission rate of these aged patients living in rural area.
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