骨科病人出院準備服務模式之建立

The purpose of this study was to investigate the need for and the effectiveness of discharge planning for hospitalized orthopedic patients. All hospitalized orthopedic patients were listed as potential study subjects. Needs assessment were performed at patients admission and three days after surgery. All discharge instructions were complete before discharge, and high-risk cases and telephone follow-up were taken by the case managers. Results showed: (1) Of the 517 cases, 57 (11.0%) were scored more than or equal to seven points and defined as ”high-risk population”. 460 were scored less than or equal to six points and defined as ”non-high-risk population”. (2) 17(29.8%) of the high-risk population and 16(3.5%) of the non-high-risk population were transferred to chronic care hospitals or nursing homes. There was a significant difference(x^2=58.912, p=.000). (3)The mean number of discharge instruction for high-risk population was 10.63(SD=1.14) and 9.98(SD=1.33) for non-high-risk population. There was a significant difference (t=-3.513, p=.000). (4)Two weeks after discharge, more than 80% of patients took their medication regularly, with rehabilitation exercises and safety precautions according to the recommendations. Two (3.5%) patients of them were readmitted and none required emergency care. Comprehensive discharge planning is needed for orthopedic patients to provide continued and high-quality health care.