A REIMBURSEMENT SYSTEM PROPORTIONATE TO THE AMOUNT OF NURSING CARE AND ASSISTANCE RENDERED FOR LONG-TERM PATIENTS
| Project/Area Number |
06454605
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Medical sociology
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| Research Institution | NIHON UNIVERSITY |
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Principal Investigator |
UMESATO Yoshimasa NIHON UNIVERSITY SCHOOL OF MEDICINE ASSOCIATE PROFESSOR, 医学部, 助教授 (60213485)
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| Co-Investigator(Kenkyū-buntansha) |
OHMICHI Hisashi NIHON UNIVERSITY SCHOOL OF MEDICINE PROFESSOR, 医学部, 教授 (60158805)
KUBO Yoshiko NIHON UNIVERSITY SCHOOL OF MEDICINE ASSISTANT, 医学部, 助手 (60060109)
TERASAKI Hitoshi NIHON UNIVERSITY SCHOOL OF MEDICINE ASSISTANT PROFESSOR, 医学部, 講師 (90227512)
HASHIMOTO Michio INTERNATIONAL UNIV.OF HEALTH CARE AND WELFARE PROFESSOR, 保健学部, 教授 (00134528)
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| Project Period (FY) |
1994 – 1995
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| Project Status |
Completed (Fiscal Year 1995)
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| Budget Amount *help |
¥5,400,000 (Direct Cost: ¥5,400,000)
Fiscal Year 1995: ¥1,700,000 (Direct Cost: ¥1,700,000)
Fiscal Year 1994: ¥3,700,000 (Direct Cost: ¥3,700,000)
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| Keywords | long-term care / patient categories / ADL assistance insurance / ADL / hospitals for the aged / nursing homes / special nursing homes / 在宅療養 |
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| Research Abstract |
In order to offer the most suitable health service and provide a reasonable a reimbursement system, we attempted to establish a classification of long-term patients that would appropriately reflect their clinical conditions and needs for care and assistance in daily life activities (ADL). Such a classification should be based on the patients' information such as can be obtained with relative ease during their stay in institutions.
In our present investigation, we conducted a survey to evaluate the amounts of nursing care and assistance in terms of three factors : 1) patients' clinical conditions and needs for assistance ; 2) subjective evaluation by nurses and ADL assistants of their sense of burden ; 3) the actual time spent for nursing care and assistance. The subjects consisted of a total of 891 patients in ten health care institutions : 203 patients in two special nursing homes ; 322 in six nursing homes ; 268 in one hospital for the aged ; 98 in one chronic hospital.
First, with the
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subjectively evaluated sense of burden as the target variable, a variance analysis was carried out, which yielded five categories according to the patient's needs for ADL assistance. Next, the patient's expression of ideas was introduced as another variabale into the analysis. This led to a classification with six categories for ADL.These categories accounted for 50% of the variance for the sense of burden felt by nursing personnel in their work. The accountability of the variance was particularly low for the chronic hospital, indicating the involvement of other factors in inducing the sense of burden among the staff. The time to provide care and assistance lengthened as the categorized degree of patient's disability advanced. Our present classification of long-term patients based on the need for care and ADL assistance appeared to be sufficiently reliable. A similar classification of patients according to the need for medical care is useful for providing a reasonable reimbursement system. Less
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Report
(3 results)
Research Products
(6 results)
