碩士 / 國防醫學院 / 公共衛生學研究所 / 89 / The aged population in Taiwan is growing rapidly and this growth is expected to expand several times larger in the coming 40 years. The demand for long-term-care services is also growing rapidly. The existing inspection for the long-term-care institutions only apply in registered ones such as nursing homes and home care services. Establishments of long-term-care institutions evaluation system and related quality standards have not yet been studied by professional institutions. In order to ensure the quality of care, eliminate potential risks, provide operational guidelines for long-term-care service providers, and upgrade their professional image, establishing an efficient reviewing and examination system, and execute periodic evaluations are tasks that ought to be carried out immediately.
Purposes of this study are to understand the attitudes among owners of long-term-care institutions toward the evaluation system and their characteristics. It is also designed to analyze viewpoints on implementation of evaluation system and factors for on selecting the evaluated items; hoping that evaluation items suitable for care providers’ characteristics can be identified and become references for implementing the evaluation system in the future. The research is conducted through structural questionnaire intended for 433 care providers in northern Taiwan. A total of 374 questionnaires are distributed, which represents an 86.4% distribution rate. 304 questionnaires are received, which represents an 81.3% respondent rate. The main findings of this study are as follow:
[1]Most care providers are female, with average age of 45 and high school education. The average time for subjects being involved in the long-term-care work is 8.2 years; and average time for operating their respective institutions is 5.5 years. The main working motivation is to meet the social demand.
[2]The common characteristics of operation are small-scale institutions located in Taipei city, privately owned, non-funded, registered, and with 11 to 30 beds. Occupants are usually referred to the centers by friends and relatives. Average monthly bed in usage is 29, and occupying rate of bed is approximately 78%.
[3]Only 1/3 of the occupants qualify for the acceptance criteria set by the institutions. About 60% of the subjects think that there is sufficient manpower. Less than 10% of the owners think that there is a shortage of manpower, and care assistants and nurses are the ones in shortage.
[4]80% of the care providers indicate that competition for the long-term-care market is vigorous, and only 40% think that their own institutions’ market competitiveness is strong. Care providers hope that the government can provide operational assistance in order to subsidize funding of the long-term-care institutions; and implement long-term-care insurance in order to help occupants or their families pay the costs and file for tax deduction.
[5]Almost 90% of the care providers think that implementing the evaluation system for long-term-care institutions is “needed”; mostly are “male” providers and institutions that claim to have “strong market competitiveness”. A larger portion of “female” providers who have been working as care providers and providers that have been “in the long-term-care business for a longer period of time” think that institutions “does not need” an evaluation system.
[6]The average rate of “accepting” the implementation of the institutions evaluation is over 80%. After step-by-step analysis, factors affecting care centers’ degree of acceptance of implementing evaluation system are discovered to have the following characteristics: “hoping that government will assist in insurance planning” and “ being satisfied with the occupancy rate” have higher degree of acceptance for implementation of the evaluation system. Providers that have been in the long-term-care business for a longer period of time have lower degree of acceptance for implementation of the evaluation system.
[7]Institutions’ “willingness” of participating in the evaluation system is over an average of 80%. After step-by-step analysis, factors affecting institutions’ willingness of participating in the evaluation system are found to have the following characteristics: care centers that are“ being satisfied with the occupancy rate” and “having stronger market competitiveness” have higher willingness of participating in the evaluation system.
[8]Approximately 60% of the care providers claim that “social policy administration office” is the best entity to execute the evaluation. After analyzing related factors, providers that think “social policy administration office” is the best evaluation entity are the ones who are “male” and “graduated from high school or career school”, where their institutions are “with more beds”, “once subsidized by the social policy administration” and “having stronger market competitiveness”. Providers of long-term-care institutions who are “female” and “graduated from colleges”; with their care centers that are “receiving no subsidy from the government” and “having weak market competitiveness” tend to think that “the Long-Term Care Professional Association” is the best evaluating entity.
[9]Care providers think that the following items are “more necessary” to be included in the evaluation when considering “hardware and equipment” (over 8 points). The 12 items ranked in order are: ventilation of the rooms, fire extinguishing equipment, lighting of the rooms, refrigeration facility in the kitchens, bathroom handles and emergency call system, bath room anti-slippery devices, anti-slippery devices for corridors and stairs, first-aid equipment, inspection of kitchen’s drinking water, non-obstructing facility, assisting equipment for getting off beds, and emergency electricity generating system. Other than those, the multi-purpose activity area (6.84 points) has lower need for installation. After step-by-step analysis, the following are the discovered characteristics of factors affecting “hardware and equipment” to be included in the evaluation system. Operators have care centers that are “hiring more part-time nursing staff” and “hoping government can assist obtainment of land (compared to insurance planning)” tend to think that including “hardware and equipment” in the evaluation system is less necessary.
[10]The only item that care providers think that is “more necessary” to be included in the evaluation system when considering “stationing of specialized personnel” is “scheduled check-ups by doctors”. Other than that, the requirement level for rehabilitation therapists, social workers, part-time nutritionists, and kinetic design therapists is the lowest (below 6 point). After step-by-step analysis, the following are the discovered characteristics of factors affecting “stationing of specialized personnel” to be in the evaluation system. Care centers with more semi-paralyzed occupants tend to indicate “stationing of specialized personnel” is a necessary evaluation item. Operators that have been in the long-term-care business for a longer period of time and have care centers that are “hoping government can assist obtainment of land (compared to insurance planning)” tend to think that including “stationing of specialized personnel” in the evaluation system is less necessary.
[11]Care providers think that the following items are “more necessary” to be included in the evaluation when considering “service contents” (over 8 points). The items ranked in order are: occupants’ sanitary situation, updates on prevention of decubitus ulcer for the occupants, guidelines and records of blood sugar and pressure tracking, dietary situation of the occupants, change of occupants’ staying channels, completeness and safekeeping of medical history and nursing records, occupants’ catheter training situation, protection of occupants’ privacy, care plans tailored to each occupant’s needs. Other than those, outdoor activity (6.53 points) is the least required. After step-by-step analysis, the following are the discovered characteristics of factors affecting “service contents” to be included in the evaluation system. Operators have care centers that are “located outside of Taipei metropolitan area (compared to Taipei)” and “hiring more professional nursing personnel” tend to think that including “service contents” in the evaluation system is more necessary.
| Identifer | oai:union.ndltd.org:TW/089NDMC0058008 |
| Date | January 2000 |
| Creators | Lin Wei Feng, 林偉峰 |
| Contributors | Seny-Yong Kao, Bing-Long Wang, 高森永, 王炳龍 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | zh-TW |
| Detected Language | English |
| Type | 學位論文 ; thesis |
| Format | 168 |
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