Research on the effectiveness of discharge planning program for aged inpatients

为了了解出院计划的状况，我们对所有3268家普通病床超过100张的综合医院（例如，不包括精神病和传染病患者的病床）进行了邮件调查。在收集到的1568份问卷中（回收率为48.0%），有1359份问卷进行了分析。在这些医院中，有1313家（96.6%）有出院困难的病例。399家（29.4%）医院设有出院计划科，设有出院计划科的医院对出院问题的处理力度更大。为了研究有无出院计划科的医院在出院计划活动方面的差异，我们对两所国立大学医院的病房护理人员进行了邮件调查。有部门的护士在病人出院时更多地处理医院外资源的支持，他们比没有部门的护士对长期护理保险有更多的了解。为了了解这些患者得到了什么支持，我们还研究了2000年至2002年东京大学医院出院计划部支持和长期护理保险服务的101名出院患者。住院后申请保险的病例有可能被介绍给护士作为护理经理。引入的服务的数量和类型取决于病人的身体和家庭情况。我们还研究了两家社区医院出院的10例65岁以上患者的出院计划实施情况和出院后情况。出院后，我们对这些病人进行了挨家挨户的调查。因此，我们发现出院计划的过程有两个方面：“病房支持”和“家庭护理协调”。“病房内支持”包括“普通护理”、“护理指导”和“信息补充”。总之，顺利的协调需要一个出院计划部门作为“桥梁”。少

To perceive the state of discharge planning, we conducted a mail survey targeting all of the 3,268 general hospitals with more than 100 general beds (e.g. this excluded beds for psychiatric and infectious disease patients). Of the 1568 collected answers (collection rate : 48.0%), 1359 were subjected to analysis. Of the hospitals, 1,313 (96.6%) had cases that had difficulties with discharge. Departments of discharge planning were present in 399 (29.4%) hospitals and hospitals with a department of discharge planning put forth more effort in discharge issues.To examine the differences in discharge planning activities between hospitals with and without a department of discharge planning, we conducted a mail survey of ward nursing staff of two national university hospitals. Nurses at hospital with the department are tackling the support about the resources outside a hospital at patient discharge more, and they had more knowledge about Long-term Care Insurance than the nurses without the dep … More artment.To understand what support these patients received, we also studied 101 discharged patients with support from the department of discharge planning at Tokyo University Hospital and with Long-term Care Insurance service in 2000 to 2002. The cases applied for the Insurance after hospital admission were likely to be introduced the nurses as a care manager. The number and type of introduced services depended on the physical and family situation of the patient.We also studied the implementation of discharge planning and condition after discharge of 10 patients over 65 years old who were discharged from two community-based hospitals. After their discharge, we made a door-to-door survey of these patients. As a result, we found that the process of discharge planning has two aspects : ‘support in ward' and ‘coordination of home care.' ‘Support in ward' includes 'ordinary care,' ‘care instruction' and ‘information supplementation.' In summary, smooth coordination requires a department of discharge planning as a ‘bridge.' Less