Hunt T E, Crichton R D
Can Med Assoc J. 1977 Jun 18;116(12):1351-5.
Although articles on studies of organized home care programs are numerous, reports of long-term effectiveness of these programs are scanty. While government spokesmen appear to advocate more widespread use of alternatives to hospitalization, there has been serious criticism of the efficiency and accomplishments of home care services. A medically oriented home care program in Saskatoon (population, less than 150 000) has grown steadily over a 16-year period and is now serving a daily average of 200 individuals. All patients have required "hospital-like care" at home and most have not ordinarily been sufficiently mobile during their time in the program to attend hospital outpatient services. Many have required "concentrated care" through daily visits of professional health personnel. The program is designed for the physically ill and disabled and is administered by the major teaching hospital in the city, although it provides services to the whole community. Over one third of the patients referred in recent years had been at home. Almost one half of the patients have undergone satisfactory rehabilitation at home. The program has also proven to be an acceptable alternative to long-term institutional care for the permanently seriously disabled, a large number of whom are elderly. The program has been able to operate at considerably less cost to the public than inpatient (hospital or institutional) services would have entailed.
虽然关于有组织的家庭护理计划研究的文章众多,但这些计划长期有效性的报告却很少。尽管政府发言人似乎主张更广泛地使用住院替代方案,但家庭护理服务的效率和成效受到了严厉批评。萨斯卡通市(人口不到15万)一个以医疗为导向的家庭护理计划在16年里稳步发展,目前每天平均为200人提供服务。所有患者在家中都需要“类似医院的护理”,而且在参与该计划期间,大多数人通常行动不便,无法前往医院门诊。许多患者需要专业医护人员每日上门进行“集中护理”。该计划是为身体患病和残疾者设计的,由该市的主要教学医院管理,尽管它为整个社区提供服务。近年来转诊的患者中有超过三分之一一直在家中。近一半的患者在家中康复情况良好。该计划还被证明是为永久性严重残疾者提供长期机构护理的一种可接受替代方案,其中很大一部分是老年人。与住院(医院或机构)服务相比,该计划能够以低得多的成本为公众提供服务。