Five types of home-visit nursing agencies in Japan based on characteristics of service delivery: cluster analysis of three nationwide surveys.
Five types of home-visit nursing agencies in Japan based on characteristics of service delivery: cluster analysis of three nationwide surveys.
复制标题
DOI：
10.1186/s12913-014-0644-8
复制
发表时间：
2014-12-20
影响因子：
2.8
通讯作者：
Fujita J
中科院分区：
文献类型：
--
作者：
Fukui S;Yamamoto-Mitani N;Fujita J
自1992年日本政府为满足居家养老者日益增长的需求而首次推出家访护理机构以来，日本的家访护理机构数量在过去20年中大幅增加。从那时起，家访护理开始为各种人群服务，如晚期癌症患者、神经系统疾病患者、精神病患者或患有慢性病的儿童;目前机构数量已达到6，801家（截至2013年4月）。然而，人们对他们在患者类型或不同地区之间的差异/相似性方面的特征细节知之甚少。在这项研究中，我们开发了一种方法来分类上门护理机构在日本各地的实际服务的基础上，以帮助改善医疗政策，使这些机构更好地提供服务。我们对来自两个国家数据库的数据进行了聚类分析（厚生劳动省每年管理的长期护理机构和职业调查[数据集1; n = 5，161]和家访护理机构每年向各自都道府县政府报告的长期护理信息发布系统[数据集2; n = 4，400，与数据集1的匹配率：84.4%]），以及我们最初对家访护理机构服务提供系统的全国传真调查结果（数据集3; n = 2，049，与数据集1的匹配率：39.3%）。聚类分析结果表明，根据服务提供系统的类型，上门护理机构可以分为五类。为了确定这些类别，我们与专家进行了13次小组讨论，以确认家访护理机构的分类适当地反映了它们的实际提供系统。这五个类别是：以护士为中心的560例（10.9%），以康复为中心的211例（4.1%），以精神病为中心的360例（7.0%），以城市为中心的1,784例（34.5%），以农村为中心的2246例（43.5%）。这五个分类系统的家访护理机构可以确保适当的医疗保健政策，将允许机构提供更好的家访护理服务的基础上，他们的病人和工作人员的特点和区域的需要。这一发现对日本和其他老龄化人口迅速增长的国家都很有价值。
The number of home-visit nursing agencies in Japan has greatly increased over the past 20 years since the Japanese government first introduced it in 1992 to meet the increased needs of home-bound elderly. Since then, home-visit nursing has come to serve for a variety of populations such as those with terminal-stage cancer, neurological diseases, psychiatric conditions, or children with chronic conditions; currently the number of agencies has reached 6,801 (as of April 2013). Yet little has been known about the details of their characteristics in terms of patient types or differences/similarities across regions. In this study, we developed a method to categorize home-visit nursing agencies throughout Japan based on their actual service delivery, in order to help improve healthcare policies allowing better services by those agencies. We performed a cluster analysis on data from two national databases (Survey of Institutions and Establishments for Long-term Care which is annually administered by the Ministry of Health, Labour and Welfare [dataset 1; n = 5,161] and Information Publication System for Long-term Care which is annually reported by home-visit nursing agencies to their respective prefectural governments [dataset 2; n = 4,400, matching rate to data set 1: 84.4%]), in addition to the results from our original nationwide Fax survey of the service delivery system of home-visit nursing agencies (dataset 3; n = 2,049 matching rate to data set 1: 39.3%). The cluster analysis suggested five categories for home-visit nursing agencies based on the type of service delivery system. For deciding of these categories, we held 13 panel discussions with specialists to confirm that the categorization of the home-visit nursing agencies appropriately reflected their actual delivery systems. The five categories were: nurse-centered (560, 10.9%), rehabilitation-centered (211, 4.1%), psychiatric-centered (360, 7.0%), urban-centered (1,784, 34.5%), and rural-centered (2246, 43.5%). This five categorization system of home-visit nursing agencies could ensure appropriate healthcare policies that will allow agencies to provide better home-visit nursing services based on their patient and staff characteristics and regional needs. The findings would be valuable both in Japan as well as in other countries with rapidly growing aging populations.
影响因子：
2.8
作者：
Fukui S;Yoshiuchi K;Fujita J;Ikezaki S
通讯作者：
Ikezaki S
影响因子：
120.7
作者：
DONABEDIAN, A
通讯作者：
DONABEDIAN, A
影响因子：
4.1
作者：
Kashiwagi M;Tamiya N;Sato M;Yano E
通讯作者：
Yano E