OBJECTIVE：The purpose of this research was to investigate the various choices that head injury patients and their families should have when considering long-term care of the patients. We analyzed the
differences and similarities of choices within social demography, the resources required for various health cares, and home care needs. As a result, we were able to predict what factors to impact the disability of the head injury patients and the long-term care decisions of the head injury patients and their families.
The research helped ensure that patients receive appropriate care as early as possible by informing the family of the crucial issues they might face when the patients are released from the hospital.
METHODS：This research divided long-term care into two kinds: Informal care by family and formal care in an organization. We based our research on Anderson’s theory (1995), a model of health service usage.
That is, long -term care is determined by patients’ behavior patterns. We considered the influential factors of using long-term care domestically and abroad to design the questionnaire for this study. The
questionnaire was evaluated for good reliability and validity. Basing on cross-section research, from July 1, 2006 to March 27, 2008 and using the questionnaire, senior nurses in one regional teaching hospital in the Southern Taiwan interviewed the head injury patients and their families by telephone for one month after they left the hospitals. At the end, we interviewed 115 patients in total.
RESULTS：The results showed that 77.4 % of the patients interviewed chose to be cared by their families;
6.1 % chose to be cared in an organization; and 16.5 % chose to be looked after by nursing persons at their homes. The first factor they considered was their degree of sickness, which accounts for 58.2% of the variance. The second factor was the availability if their family can take care of them, which accounts for 46.9 % of the variance. This is also related to patients’ age, consciousness level, degree of their daily living activities on their own, special medical care they have, complications, their serious degree of
sickness, and their living at home. After linear regression analyses, we found that the disability of the head injury patients is also related to patients’ age, consciousness level, the charge for medical treatment. After logistic regression analyses, we found that the important factors which influence long-term care choices were: Patients’ activities of daily living, their living at home, and their birthplaces.
CONCLUSION：In the study, we found that the head injury patients who need long-term care would stay at home mainly and some would enter hospital or nursing home. Besides, the main factors were patients’
age, and consciousness level. Patients’ activity of daily living was the important factors that influence long-term care choices. For this reasons, all hospitals ought to interfere in this kind of patients’ discharge plan, and to build a good transfer system between hospitals. Therefore, we suggested all hospitals have to strengthen the discharge plan and to provide the suitable information which the patients’ families need.
This is to ensure the patients get continuous care after they left the hospitals. When Policymakers make the health policy should consider the elderly economic ability and ethic subgroup that would affect the institutional long-term care utilization.
