Factors Influencing Patients Using Long-Term Care Service of Discharge Planning by Andersen Behavioral Model: A Hospital-Based Cross-Sectional Study in Eastern Taiwan
Abstract
:1. Introduction
2. Methods
2.1. Background Information
2.2. Data Collection
2.3. Statistical Analysis
3. Results
3.1. Characteristic of the Patients Who Receiving the Discharge Planning Service
3.2. The Influencing Factors Affecting Patients Who Received the Discharge Planning Service of Long-Term Care 2.0
3.3. The Factors and Degree of Influence for Connecting Patients from Discharge Planning Service to Long-Term Care 2.0
4. Discussion
4.1. Characteristic of the Patients Who Received the Discharge Planning Service
4.2. The Influencing Factors Affecting That Patients Who Had Received the Discharge Planning Service Utilized Long-Term Care 2.0
4.3. The Factors and Degree of Influence for Connecting Patients from Discharge Planning Service to Long-Term Care 2.0
5. Study Limitation
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Survey Questionnaire | ||
---|---|---|
Good morning/afternoon, sir/madam, this is Ms Yi-Chien Chen, an interviewer from Taipei Veterans General Hospital Yuli Branch, Hualien of Taiwan. The purpose of our study is to know the willingness of people who had already accepted the discharge planning service to accept long-term care service. Please rest assured that your telephone number was randomly selected from our database and your information will be kept strictly confidential and used for aggregate analysis only. If you have any questions about the research, you can call 886-3-8883141 to talk to our supervisor. If you want to know more about the rights as a participant, please contact Meiho University of Taiwan at 886-8-7799821#8293 during office hours. For quality control purpose, our conversation may be recorded but will be destroyed shortly after our quality control process is complete. | ||
Is it okay for us to start this survey? | □ Yes | □ No |
We would like to ask you about your personal information: | ||
1. How old are you? | ______years old | |
2. Sex? | □ Male | □ Female |
3. Medical accessibility? | □ Yes | □ No |
4. Tubal insertion? | □ Yes | □ No |
5. Card for people with disability? | □ Yes | □ No |
6. Cerebrovascular disease? | □ Yes | □ No |
7. Dementia? | □ Yes | □ No |
8. Osteoarthritis? | □ Yes | □ No |
9. Coronary or cardiovascular disease? | □ Yes | □ No |
10. Chronic obstructive pulmonary or asthma? | □ Yes | □ No |
11. Malignancy? | □ Yes | □ No |
12. End stage renal disease? | □ Yes | □ No |
13. Diabetic mellitus? | □ Yes | □ No |
Thank you for your help. |
References
- National Development Council. Population Projections for the R.O.C. (Taiwan). 2021. Available online: https://pop-proj.ndc.gov.tw/index.aspx (accessed on 19 February 2021).
- The World Bank. Population Ages 65 and Above (% of Total Population). 2016. Available online: https://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS (accessed on 6 July 2019).
- The World Bank. Live Long and Prosper: Aging in East Asia and Pacific. 2015. Available online: http://documents.worldbank.org/curated/en/832271468184782307/Live-long-and-prosper-aging-in-East-Asia-and-Pacific (accessed on 1 July 2019).
- Iwagami, M.; Tamiya, N. The Long-Term Care Insurance System in Japan: Past, Present, and Future. JMA J. 2019, 2, 67–69. [Google Scholar] [PubMed] [Green Version]
- Ministry of the Interior, Taiwan. The Elderly Population Broke through 14%. Taiwan Officially Entered the Advanced Society. Available online: https://www.moi.gov.tw/chi/chi_news/news_detail.aspx?type_code=02&sn=13723 (accessed on 1 July 2019).
- Heather, H.; Henry, B.; Donald, S.; Michelle, B.F.; Jennifer, J. Patient perceptions of hospital discharge: Reliability and validity of a patient continuity of care questionnaire. Int. J. Qual. Health Care 2008, 20, 314–323. [Google Scholar] [CrossRef]
- Ministry of Health and Welfare, Taiwan. National Ten-Year Long-Term Care Plan 2.0. Available online: https://www.mohw.gov.tw/cp-4344-46546-2.html (accessed on 11 January 2020).
- Ministry of Health and Welfare, Taiwan. Long-Term Care 2.0. Available online: https://www.mohw.gov.tw/cp-4350-46708-1.html (accessed on 17 February 2021).
- Ministry of Health and Welfare, Taiwan. Long-Term Care 2.0. Drives Results 2018. Available online: https://www.ey.gov.tw/File/BB351451C2119BFB?A=C (accessed on 1 July 2019).
- Ministry of Health and Welfare, Taiwan. Survey Report on the Status of the Elderly in the Republic of Taiwan in 102 Years. 2018. Available online: https://www.slideshare.net/hseyilishih/102-10310 (accessed on 1 July 2019).
- Hsu, H.C.; Chen, C.D.; Hsiao, C.Y.; Liu, Y.L. The Effectiveness of Discharge Planning and Factors Affecting the Discharge Care Model. Taiwan J. Fam. Med. J. 2009, 19, 192–202. [Google Scholar]
- See, L.C.; Chuang, K.L.; Li, H.F.; Wang, H.H.; Hu, W.C.; Wang, S.H.; Tsai, Y.H.; Jeng, S.H. Discharge planning: Care model, Readmission rate, and Mortality Rate after Discharge. Chung Shan Med. J. 2011, 22, 23–33. [Google Scholar]
- Rodakowski, J.; Rocco, P.B.; Ortiz, M.; Folb, B.; Schulz, R.; Morton, S.C.; Leathers, S.C.; Hu, L.; III, E.J. Caregiver Integration during Discharge Planning of Older Adults to Reduce Resource Utilization: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J. Am. Geriatr. Soc. 2017, 65, 1748–1755. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ministry of Health and Welfare, Taiwan. Ministry of Health and Welfare, Taiwan. 2018. Available online: https://dep.mohw.gov.tw/DONAHC/mp-104.html (accessed on 1 July 2019).
- Lin, F.O.; Luk, J.K.; Chan, T.C.; Mok, W.W.Y.; Chan, W.U. Effectiveness of a discharge planning and community support programme in preventing readmission of high-risk older patients. Hong Kong Med. J. 2015, 21, 208–216. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Chen, L.S.; Kuo, Y.H.; Chen, H.C. Applying Andersen’s Healthcare Utilization Model to Explore the Impact of Medical Resource Sufficiency on the Cross-regional Healthcare Utilization. Med. J. South Taiwan 2018, 14, 72–81. [Google Scholar]
- Andersen, R.; Newman, J.F. Societal and individual determinants of medical care utilization in the United States. Milbank Mem. Fund. Q. Health Soc. 1973, 51, 95–124. [Google Scholar] [CrossRef] [Green Version]
- Liao, H.C. Spatial Accessibility to Pediatric Services in Taiwan. J. Public Adm. 2013, 44, 1–39. [Google Scholar]
- IBM Japan Health Insurance Association, Japan. The Long-Term Care Insurance Program. 2013. Available online: http://www.ibmjapankenpo.jp/eng/member/outline/system03.html (accessed on 7 July 2019).
- US Department of Health and Human Services, American. Who Need Care? 2017. Available online: https://longtermcare.acl.gov/the-basics/ (accessed on 7 July 2019).
- Tseng, H.Y.; Shih, Y. Factors Associated with Welfare Services Used by Elderly Persons Living Alone in Taipei City. J. Long-Term Care 2010, 14, 177–197. [Google Scholar]
- Lin, M.H.; Kuo, R.N.; Chin, W.C.B.; Wen, T.H. Profiling the patient flow for seeking healthcare in Taiwan: Using gravity modeling to investigate the influences of travel distance and healthcare resources. Taiwan J. Public Health 2016, 35, 136–151. [Google Scholar] [CrossRef]
- Steinbeisser, K.; Grill, E.; Holle, R.; Peters, A.; Seidl, H. Determinants for utilization and transitions of long-term care in adults 65+ in Germany: Results from the longitudinal KORA-Age study. BMC Geriatr. 2018, 18, 172. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ministry of Health and Welfare, Taiwan. Statistics on the Cause of Death in Taiwan. 2018. Available online: https://www.mohw.gov.tw/cp-16-48057-1.html (accessed on 7 July 2019).
- Black, R.L.; Duval, C. Diabetes Discharge Planning and Transitions of Care: A Focused Review. Curr. Diabetes Rev. 2019, 15, 111–117. [Google Scholar] [CrossRef] [PubMed]
- Kirby, S.E.; Dennis, S.M.; Jayasinghe, U.W.; Harris, M.F. Patient related factors in frequent readmissions: The influence of condition, access to services and patient choice. BMC Health Serv. Res. 2010, 21, 216. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Greysen, S.R.; Stijacic, C.I.; Auerbach, A.D.; Covinsky, K.E. Functional impairment and hospital readmission in Medicare seniors. JAMA Intern Med. 2015, 175, 559–565. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Pinelli, V.A.; Papp, K.K.; Gonzalo, J.D. Interprofessional Communication Patterns During Patient Discharges: A Social Network Analysis. J. Gen. Intern. Med. 2015, 30, 1299–1306. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Wen, C.P.; Chang, C.H.; Tsai, M.K.; Lee, J.H.; Lu, P.J.; Tsai, S.P.; Wen, C.; Chen, C.H.; Kao, C.W.; Tsao, C.K.; et al. Diabetes with early kidney involvement may shorten life expectancy by 16 years. Kidney Int. 2017, 92, 388–396. [Google Scholar] [CrossRef] [PubMed]
- Mitchell, J.; Krout, J.A. Discretion and service use among older adults: The behavioral model revisited. Gerontologist 1998, 38, 159–168. [Google Scholar] [CrossRef] [PubMed]
- Liu, L.F.; Chen, J.J.; Lee, Y.C.; Liu, C.C. Exploring the home services utilization and its influencing factors for case closures in Taiwan long-term care system. Taiwan J. Public Health 2018, 37, 539–553. [Google Scholar] [CrossRef]
Variable | N (%) |
---|---|
Predisposing factors | |
Age (M ± S.D) | 73.7 ± 13.3 |
<50 years | 16 (5.7) |
50–65 years | 47 (16.8) |
>65 years | 217 (77.5) |
Sex | |
Male | 160 (57.1) |
Female | 120 (42.9) |
Enabling factors | |
Medical accessibility | |
Yes | 121 (43.2) |
No | 159 (56.8) |
Need factors | |
Tubal insertion | |
Yes | 75 (26.8) |
No | 205 (73.2) |
Card for person with disability | |
Yes | 92 (32.9) |
No | 188 (67.1) |
Chronic diseases | |
Cerebrovascular disease | 61 (21.8) |
Dementia | 27 (9.6) |
Osteoarthritis | 94 (33.6) |
Coronary or cardiovascular disease | 77 (27.5) |
Chronic obstructive pulmonary or asthma | 94 (33.6) |
Malignancy | 22 (7.9) |
End stage renal disease | 18 (6.4) |
Diabetic mellitus | 99 (35.4) |
Factors | LTC | No LTC | X2 | p-Value | ||
---|---|---|---|---|---|---|
Total | 184 (65.7) | 96 (34.3) | ||||
Predisposing | Age (M ± S.D) | 75.1 ± 10.9 | 70.8 ± 16.5 | 14.364 ** | 0.001 | |
<50 years | 5 (31.3) | 11 (68.8) | ||||
50–65 years | 25 (53.2) | 22 (46.8) | ||||
>65 years | 154 (71.0) | 63 (29.0) | ||||
Sex | Male | 105 (65.6) | 55 (34.4) | 0.001 | 0.971 | |
Female | 79 (65.8) | 41 (34.2) | ||||
Enabling | Medical accessibility | Yes | 91 (75.8) | 30 (24.2) | 8.522 | 0.004 |
No | 93 (58.5) | 66 (41.5) | ||||
Need | Tubal insertion | Yes | 49 (65.3) | 26 (34.7) | 0.007 | 0.935 |
No | 135 (65.9) | 70 (34.1) | ||||
Card for person with disability | Yes | 72 (78.3) | 20 (21.7) | 9.573 ** | 0.002 | |
No | 112 (59.6) | 76 (40.4) | ||||
Chronic diseases | ||||||
Cerebrovascular disease | Yes | 50 (82.0) | 11 (18.0) | 9.144 ** | 0.002 | |
No | 134 (61.2) | 85 (38.8) | ||||
Dementia | Yes | 19 (70.4) | 8 (29.6) | 0.288 | 0.592 | |
No | 165 (65.2) | 88 (34.8) | ||||
Osteoarthritis | Yes | 62 (66.0) | 32 (34.0) | 0.004 | 0.951 | |
No | 122 (65.6) | 64 (34.4) | ||||
Coronary or cardiovascular disease | Yes | 61 (79.2) | 16 (20.8) | 8.599 ** | 0.003 | |
No | 123 (60.6) | 80 (39.4) | ||||
Chronic obstructive pulmonary or asthma | Yes | 67 (71.3) | 27 (28.7) | 1.943 | 0.163 | |
No | 117 (62.9) | 69 (37.1) | ||||
Malignancy | Yes | 16 (72.7) | 6 (27.3) | 0.521 | 0.470 | |
No | 168 (65.1) | 90 (34.9) | ||||
End stage renal disease | Yes | 13 (72.2) | 5 (27.8) | 0.362 | 0.548 | |
No | 171 (65.3) | 91 (34.7) | ||||
Diabetic mellitus | Yes | 75 (75.8) | 24 (24.2) | 6.856 ** | 0.009 | |
No | 109 (60.2) | 72 (39.8) |
Factors | OR | 95% CI | p-Value | |
---|---|---|---|---|
Predisposing | Age | |||
50–65 years vs. <50 years | 3.991 * | [1.031, 15.452] | 0.045 | |
>65 years vs. <50 years | 9.773 *** | [2.752, 34.705] | <0.001 | |
Enabling | Medical accessibility | |||
Yes vs. No | 2.300 ** | [1.290, 4.103] | 0.005 | |
Need | Card for person with disability | |||
Yes vs. No | 2.925 ** | [1.514, 5.652] | 0.001 | |
Cerebrovascular Accident | ||||
Yes vs. No | 2.357 * | [1.095, 5.076] | 0.028 | |
Coronary/cardiovascular disease | ||||
Yes vs. No | 2.526 ** | [1.300, 4.908] | 0.006 | |
Diabetic mellitus | ||||
Yes vs. No | 2.191 * | [1.172, 4.097] | 0.014 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Chen, Y.-C.; Chang, W.-T.; Huang, C.-Y.; Tseng, P.-L.; Lee, C.-H. Factors Influencing Patients Using Long-Term Care Service of Discharge Planning by Andersen Behavioral Model: A Hospital-Based Cross-Sectional Study in Eastern Taiwan. Int. J. Environ. Res. Public Health 2021, 18, 2949. https://doi.org/10.3390/ijerph18062949
Chen Y-C, Chang W-T, Huang C-Y, Tseng P-L, Lee C-H. Factors Influencing Patients Using Long-Term Care Service of Discharge Planning by Andersen Behavioral Model: A Hospital-Based Cross-Sectional Study in Eastern Taiwan. International Journal of Environmental Research and Public Health. 2021; 18(6):2949. https://doi.org/10.3390/ijerph18062949
Chicago/Turabian StyleChen, Yi-Chien, Wei-Ting Chang, Chin-Yu Huang, Peng-Lin Tseng, and Chao-Hsien Lee. 2021. "Factors Influencing Patients Using Long-Term Care Service of Discharge Planning by Andersen Behavioral Model: A Hospital-Based Cross-Sectional Study in Eastern Taiwan" International Journal of Environmental Research and Public Health 18, no. 6: 2949. https://doi.org/10.3390/ijerph18062949