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潮漠阮
5 years ago
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1 IDS 96 IDS IDS IDS IDS /274 B C HbA1C39~55%2 60HbA1c<7%46~ <7mg/dl43~ % 46.4% 45.5% IDS IDS IDS Integrated Delivery System IDS IDS 15,

2 2010 Vol.2 No.2 9.1% 400 3600 3 50 10 3 IDS 9413,445 75% 5,842 33.

2 Vol.2 No.2 9.1% IDS 9413,445 75% 5, % 6,000 IDS 1 98% IDS IDS [1,2] IDS 65 [1] [3-7] 3 [8] 1 IDS 97IDS IDS

3 IDS IDS IDS IDS B C IDS IDS i-care Login.aspxi-care IDS 2 5 USB i-care 1IDS 1. HbA1C HbA1C 7 60 / CHO TG HDL LDL CHO 200 TG /40 60 /40 4. UA UA 7mg/dl 60 /40 5.B GOT GPT AFP 6.C GOT GPT AFP GOT 40 GPT 40 GOT 40 GPT / /---

4 Vol.2 No.2 2 IDS i-care 3 i-care

5 i-care 5 i-care

6 Vol.2 No.2 6 IDS IDS IDS 6

992 2 7 7IDS 277 2HbA1C 39~55%2 60 HbA1c<7%46~63 40 893 3 2 60 1 74 2 3 <7mg/dl43~50 40

7 IDS 277 2HbA1C 39~55%2 60 HbA1c<7%46~ <7mg/dl43~ i-care6 IDS B CIDS BC % 46.4% 45.5% 6 IDS 4 IDS IDS IDS IDS

8 Vol.2 No.2 25 IDSHbA1c HbA1c7 HbA1c %* %* %* %* % % 9 0 0% 9 0 0% % % % % % % % % HbA1c %* %* %* %* %* %* 0 0 0% 0 0 0% %* % %* %* 0 0 0% % %* %* * 35 IDS7mg/dl % %* %* % % % 0 0 0% 0 0 0% 4 0 0% %* % %* % %* % % % %* %* %* %* %* 0 0 0% 0 0 0% 0 0 0%* % %* %* %* %* %* %* *

9 IDS IDS 99/5 99/6 99/7 99/ IDS IDS B C % 14% 3% 1% 25% 10% IDS B C % GOT 40 GPT 40 GOT 40 GPT 40 UA 7 CHO 200 TG * * * %

10 Vol.2 No.2 [9] IDS [10] IDS 4 HbA1c [11] IDS 69.3% 61.3% 46.7% 22.8% 15.2% [12] i-care IDS 4 IDS IDS IDS IDS IDS IDS ;3(3): : 2002;3(2):

11 ;5(2): The Effects of Providers' Perception of the Diabetes Disease Management Program on Their Participation 2008;18(2): ;24:53-78

12 12 Quality management in rual health care- experience from the Jen- Ai integrated delivery service (IDS) plan Chih-Kuei Lee 1, Mei-Fang Pan 2, Pan-yu Tseng 2, Hsin-Hui Tserg 2 Studies had shown that the Integrated Delivery Service (IDS) plans by the National Health Insurance Bureau were effective in enhancing convenience, accessibility and comprehensiveness of health care to people in rural areas in Taiwan. Yet most IDS plans do not incorporate disease management programs for chronic diseases due to lack of manpower and professionals. Puli Christian Hospital (PCH) IDS Jen-Ai plan started disease management for chronic care in 2007, and monitored a set of quality indicators in the IDS annual audit process. This article introduced the processes and outcomes of disease management in IDS Jen-Ai plan. We analyzed all disease management cases recruited from January 1, 2007 to September 30, The scope of disease management includes diabetes, hypertension, hyperlipidemia, hyperuricemia, hepatitis B, and hepatitis C. In the first phase (year 1 to year 3), up to 277 diabetic subjects were recruited. HbA1c check up rates were 39-55% (The goal is 60% of subjects receiving HbA1c tests 2 times per year). The glucose control rates (HbA1c<7%) were between Up to 893 hyperuricemic subjects were recruited. Uric acid check up rate was 74% in the first year (The goal is 60% of subjects receiving uric acid tests 2 times per year). The uric acid control rates (<7 mg/dl) were between 43-50In the second phase (year 4), most indicators for disease control were below the set standards and varied greatly among IDS health care organizations. With proper communication and information systems, disease management can reveal the accountability of an IDS plan in rural mountain areas. However, factors associated with provider participation and trend of unfavorable outcomes over time should be explored. Key words: disease management, case management, IDS, rural area Department of Community Health 1, Mountain Medical 2, Puli Christian Hospital Received: September 1, 2010; Accepted: September 30, 2010 Corresponding author: Mei-Fang Pan Contact address:department of Mountain Medical, Puli Christian Hospital, Puli, Taiwan

护理10期.indd

护理10期.indd 广西壮族自治区护理人力资源配置现状及其公平性研究邹雄贝为武黄芳苏惠李连凤 [ 摘要 ] 目的 : 通过对 2 011 年广西壮族自治区 3 大经济区域 14 个辖市护理人力资源的现状及其配置公平性进行分析, 为卫生行政部门进一步优化护