[[alternative]]The relationship between facility characteristics

Abstract

[[abstract]]隨人口老化、家庭結構改變、社會變遷因素影響使護理之家供給增加，其照護品質良窳漸受重視。本研究旨在初探護理之家機構特性（經營型態、規模、佔床率、護理人員護理時數、病患服務員護理時數）與照護品質（壓瘡率、跌倒率、轉∕住至急性照護機構率、感染率、使用身體約束率）的相關性。 本研究參考Donabedian品質管理理論模式，採描述相關性設計，於89年10月至12月為期3個月調查，依經營型態為分層基礎，按所佔母群體比例隨機抽樣，以郵寄結構式問卷方式調查台灣地區39家立案護理之家，有效樣本數共32家，有效回收率82﹪。利用描述性統計及邏輯斯迴歸方式進行資料分析。 本研究結果為控制住民特性後，獨立型態護理之家比醫院附設型態護理之家傾向低跌倒率與低感染率，且規模大的機構傾向有高跌倒率。本研究結論為經營型態與規模為未來照護品質提昇之主要考量因素，此外並針對本研究進行之限制提出建議，及對未來研究、實務、教育、政策制定應用加以討論。[[abstract]]In recent years, the numbers of nursing home are increasing rapidly to take care of the aging population because of the change in the structure of the family and society. Therefore, the government and the public have concerned the quality of care in nursing homes. The purpose of this study was to examine the relationship between the characteristics of nursing homes (e.g. ownership, size, occupancy rate, RN hours per patient day, NA hours per patient day) and the outcome of quality care (e.g. pressure ulcer rate, falls rate, rate of transfer/discharge to in-patient acute care, infection rate, rate of use of physical restraint). Based on the Donabedian’s quality management model, a descriptive correctional design was adopted. A stratified random proportionate sampling procedure was used for selecting 39 homes from 123 legitimate nursing homes. Data were collected from a tree-part post survey completed by 32 / 39 (82%) administrators of homes. Data was analyzed by using descriptive statistics and logistic regression at organizational-level. Results of this study revealed that after controlling the resident characteristics, the freestanding nursing homes had lower falls rate and infection rate; nursing homes with larger size had higher falls rate. Findings hold important implications for professional education, research, administration and policymaking. Recommendations were discussed for further study