Health Care Utilization of Home Care Patients at an Academic Medical Center in Taiwan

Abstract

The home care agency of the hospital should pay more attention to provision of comprehensive care and review of drug prescribing.

Learning to be a family caregiver for severely debilitated stroke survivors during the first year in Taiwan

“…Administering medication is particularly problematic for caregivers. The reported average medications per day for home care survivors are 5.3 to 6.6 and 42% of them have four to nine medications per day (Chou, et al, 2006;Ni, Dai, Yip & Liang, 1998). Family caregivers have difficulty administering multiple medications and lack the ability to understand the instructional leaflet (Chiu, 1998).…”

“…Infection is the major cause of death for stroke patients. The overall unplanned re-hospitalizations are 44-77% (Chou, et al, 2006;Chung, et al, 2003;Lo, et al, 1991;Yeh & Wen, 2001). Like the reasons for death, the major reasons for re-hospitalizations are pneumonia, pain, sepsis, UTI, and gastrointestinal bleeding (Chen, et al, 2003;Chou, et al, 2006;Dai, et al, 2002).…”

“…Reasons for re-hospitalizations include sputum problems, UTI and gastric bleeding (Chen et al, 2003;Chou, et al, 2006;Dai et al, 2002). According to Chiu, Hong, Shyu and Chang (1999); Chuang, Wu, Ma, et al, (2005);Chung, et al (2003), and Tseng (2003), the total hospital expenditures and family costs in hospital are around 223,000 to 334,500 NT dollars (8,260 to 12,390 US dollars) for each stroke episode of 20…”

“…For elders receiving home care services during the first six months post discharge, only 4-13% have an improvement in self-care ability (Hung, et al, 1999;Liao, Shao, Lee & Shyu, 2000;Tu & Wang, 1998;Yeh & Wen, 2001). The reported hospital re-admission rates are 44-77% (Chou et al, 2006;Chung, Chou, Chuang & Chen, 2003;Lo, Chen & Hu, 1999;Yeh & Wen, 2001). The major reasons for re-hospitalization include pneumonia, pain, sepsis, urinary tract infection (UTI), and gastrointestinal bleeding (Chen, Yeh & Shyu, 2003;Chou, et al, 2006;Dai, Wu & Weng, 2002).…”

“…The reported hospital re-admission rates are 44-77% (Chou et al, 2006;Chung, Chou, Chuang & Chen, 2003;Lo, Chen & Hu, 1999;Yeh & Wen, 2001). The major reasons for re-hospitalization include pneumonia, pain, sepsis, urinary tract infection (UTI), and gastrointestinal bleeding (Chen, Yeh & Shyu, 2003;Chou, et al, 2006;Dai, Wu & Weng, 2002). In total, infections account for over 60% of deaths and unplanned re-hospitalization for home health care stroke survivors.…”