| 摘要: | 本研究主要在描述一位藥局藥師提供藥事居家照護一年期間，減少高診次個案就醫次數，照護期間給藥日數，門診醫療花費之情形，以及提升病人生活品質之情形。自民國103年三月至十二月期間訪視83位個案，平均每人提供居家照護7.99次，年齡範圍從40歲到81歲不等，而年齡分布在 65~88 歲之間的個案人數最多，有45位佔54.2%。個案在照護前一年的平均就診次數，與照護後個案(當年最後訪視日)平均就診次數比較，有統計上顯著下降29.87次(p<0.05)。在照護前一年的平均給藥日數，與照護後個案(當年最後訪視日)平均給藥日數比較，有統計上顯著下降174.27日(p<0.05)。本研究測量個案滿意度與健康相關生活品質。超過 90%的個案都滿意(五級分之第四級)藥師的照護，並有意願(五級分之第四級)繼續接受藥師的照顧。在健康相關生活品質方面，個案的整體健康評分照護前後平均有5.06分的提升，表現最好的可以由45分提升到85分(評分由0分至100分)。依據健保署的統計在民國103年度結束的高診次116位收案人數，其民國102年度(照護前)的醫療費用為7,084,872元，全年照護完成後的醫療費用為5,762,420元，共減少了1,322,452元，降低18.67%。
This thesis was to present the author’s performance on decreasing thenumber of clinical visits, identify and resolve drug therapy problems, enhancing quality of life of the patients, and the overall reduction of healthcare expenditures. Therefore, the outcomes of the study were measured from three dimensions: clinical outcomes, humanistic outcomes, and economic outcomes. Ofthe total 83 patients under the study period, pharmacist conducted in average 7.99 home visits per patient. Their age ranges from 40 to 81 years old and the female patients accounts for 62.4%. Patients in the range of 65 to 88 years old have the largest number, 45(54.2%) persons, and accounts for 68.6% of the total. Number of clinical visits at early and late stages showed significant decreased 29.87(p<0.05). More than 90 % of the patients under this study were highly agreed that pharmacist can indeed help them, and highly satisfied with the home care service offered by the pharmacists, and patients are willing to continue such pharmaceutical care performed by the pharmacists. In addition, more then half of the patients their health related quality of life increased with some increased even from 45 up to 85, on a scale of 0 ~ 100. Based on statisticsNHIA,at the end of July 2014.The number of cases recorded are 116, total medical expenses in 2013 is NT7,084,872, in 2014 is NT 5,762,420. It was reduced 18.67%. |
