Study objectives and significance
Generally, patients go to hospitals or clinical offices for seeking health care service. However, some studies reveal that old patient or those who have disability would get hurt and expose in some dangerous situation, such as falls and infection. As the reasons, the rehabilitation delivery model, which sends the service to patients¡¦ community, is needed. The community delivering-rehabilitation model that this study focuses on integrates hospital center and retirement home. This study is to compare the community delivering-rehabilitation model and general delivery model that patients go to hospital for rehabilitation service.
Data and methods
In one-year study duration from Nov. 1, 2002 to Oct. 31, 2003, the Barthel Index score from two delivery models were collected every 3 months. On the other hand, patients¡¦ rehabilitation costs were collected once 3 months, too. The study unit is individual unit. Cost-effectiveness analysis (CEA) was used here to be a standard comparing tool. CEA was computed by dividing the cost that patient spent in 3 months into the Barthel Index score which patient improved his functional status. Independent variables include environmental factors and structural factors The Environment factors include rehabilitation delivery model and the patient-therapist ratio. Structural factors include chain-affiliation status, instrumental volume and status. The General Estimating Equation was used here for comparing longitudinal dependent data.
Results
The study reveals that environmental factors and structural factors affect the performance of rehabilitation units. Environmental factors positively affect the rehabilitation effect. Structural factors negatively affect the rehabilitation effect. On the other hand, Environmental factors positively affect the rehabilitation efficiency. Structural factors negatively affect the rehabilitation efficiency.
Conclusion and the project¡¦s relevance to public health
The community delivering-rehabilitation model has better rehabilitation effect, but on the aspect of efficiency, is not as good as general delivery model. However, the community delivering-rehabilitation model has good accessibility to patient. It also concerns patient safety. If the model can improve its efficiency, the promotion of health can be further implied in community delivering-rehabilitation model.
| Identifer | oai:union.ndltd.org:NSYSU/oai:NSYSU:etd-0702104-164332 |
| Date | 02 July 2004 |
| Creators | Huang, Shu-yen |
| Contributors | Shu-Chuan Jennifer Yeh, Jin-Yuan Chern, Hsueh-Wen Chang |
| Publisher | NSYSU |
| Source Sets | NSYSU Electronic Thesis and Dissertation Archive |
| Language | Cholon |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.lib.nsysu.edu.tw/ETD-db/ETD-search/view_etd?URN=etd-0702104-164332 |
| Rights | campus_withheld, Copyright information available at source archive |
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