Service needs of residents in community-based long-term care facilities in northern Taiwan.

摘要

AIM: The purpose of this study was to quantify the service needs of residents in community-based long-term care (LTC) facilities and to determine their predictors. BACKGROUND: Disabled older family members in Taiwan are often eventually sent to community-based LTC facilities. Many service needs of these residents are likely to go unmet. METHODS: A cross-sectional survey was used. This involved purposive sampling of 132 residents from 10 LTC facilities in Taipei City. A previously developed LTC service need assessment scale was used to collect information about the residents' needs in terms of five kinds of LTC services, namely health education, skilled nursing services, referral services, activities of daily living (ADL) assistance and instrumental activities of daily living assistance. RESULTS: The mean age of residents was 75.2 years. The average period of institutionalization was 21.93 months. Overall, 70% of the residents had either complete or partial ADL function dependency. Among the specific ADL function dependencies of the residents, inability to take a bath was the most common. The most significant predictors of service needs were health status, age, number of children, number of medical diagnoses and whether the stay is self-choice. These combined variables explained between 25.5% and 41.6% of the variance of the need for LTC services. CONCLUSION: The findings of this study show that age, health status, number of children, number of medical diagnoses and whether the stay is self-choice are significant determinants of residents' needs in terms of LTC. Assessment of the extent to which facilities meet the residents' needs is the first step in providing the most cost-effective allocation of scarce resources. RELEVANCE TO CLINICAL PRACTICE: It is suggested that, if reimbursement by the National Health Insurance system of physician visits, including psychiatric visits, to LTC facilities were allowed, this would improve quality of care.