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澳大利亚养老院机构中的资金制度及其对提供优质姑息护理的影响。

Funding regimes and the implications for delivering quality palliative care nursing within residential aged care units in Australia.

作者信息

Allen S, O'Connor M, Chapman Y, Francis K

机构信息

Monash University Gippsland Campus, School of Nursing and Midwifery, Churchill, Victoria, Australia.

出版信息

Rural Remote Health. 2008 Jul-Sep;8(3):903. Epub 2008 Aug 4.

Abstract

BACKGROUND

Funding to Australian residential aged care units has undergone recent reforms. Parallel with these fiscal developments, the Australian Government commissioned the Guidelines for a Palliative Approach in Residential Aged Care that addressed the inequities of service associated with dying in residential aged care.

AIMS

This literature review describes the variances in funding between Australian residential aged care facilities (RACFs), and multi-purpose services (MPSs) and, in doing so, exposes the impact that funding variances have on the delivery of end-of-life and palliative care to residents in aged care units.

FINDINGS

Government funding policy allowed RACFs an opportunity to adopt and implement the guidelines and standards, through funding individual resident identified healthcare needs. By comparison, MPSs are funded through an agreed (government and organisation) number of beds to provide nursing care to residents. This funding allocation forms MPSs' general consolidated revenue for service delivery.

KEY ISSUES

RACFs identify nursing care needs of residents through a residential classification scale, while management of MPSs allocates funding to service provision.

CONCLUSIONS

The significant factor of funding beds (MPS) not the delivery of nursing care required by residents (RACFs) does impact on the implementation of a palliative approach for residents and, hence, the delivery of quality nursing care. Nursing management should consider funding implications when allocating resources to services in MPSs.

摘要

背景

澳大利亚的老年护理机构资金近期经历了改革。与这些财政发展同步,澳大利亚政府委托制定了《老年护理机构姑息治疗指南》,该指南解决了与老年护理机构临终服务相关的不公平问题。

目的

本文献综述描述了澳大利亚老年护理机构(RACF)和多用途服务机构(MPS)之间的资金差异,并借此揭示资金差异对老年护理机构居民临终关怀和姑息治疗服务提供的影响。

研究结果

政府资助政策使RACF有机会通过资助个体居民确定的医疗需求来采用和实施指南及标准。相比之下,MPS通过商定的(政府和机构)床位数量获得资金,为居民提供护理服务。这种资金分配构成了MPS提供服务的一般综合收入。

关键问题

RACF通过居住分类量表确定居民的护理需求,而MPS的管理则将资金分配用于服务提供。

结论

按床位(MPS)而非居民所需护理服务(RACF)进行资金分配这一重要因素,确实会影响为居民实施姑息治疗方法,进而影响优质护理服务的提供。护理管理部门在为MPS的服务分配资源时应考虑资金问题。

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