物理治療介入健保系統長期使用呼吸器患者整合性照護之探討

Background and Purposes: Integrated delivery system has been provided started since 2000 for ventilator patients. These patients were thus transferred to local hospitals or so called respiratory care ward after prolonged use of ventilator. Our study firstly aimed to report the utilization of physical therapy in patients with mechanical ventilation from July to December, 2001. Secondly, it made comparison in demographic data and diagnosis distribution between the patient groups with and without physical therapy who used invasive ventilator in local hospitals during this period. Methods: National health insurance database 2001 after systemic sampling was released from National Health Institute and used in this study. Descriptive statistics, t-test, and Chi-square test for group comparison were used for data analysis. Results: There were 4,001 patients on mechanical ventilator and 24.9% (n=997) among them who used the ventilator more than 21 days during the period of July through December, 2001. The utilization rate of physical therapy was 3.8% among all these patients. There were no differences in distribution of gender, age, or diagnosis between patient groups with or without physical therapy intervention in local hospitals with long-term invasive mechanical ventilation. The leading diagnosis was respiratory diseases, followed by circulatory diseases in both groups. Conclusion: We suggest to promote the utilization of physical therapy in patients with long-term mechanical ventilation. Physical therapists should actively involve in the team for caring these patients throughout the different phases of integrated delivery system in order to enhance their function and quality of life.