Due to the facts of the increased aged population and chronic diseases, the government has focused on how to reduce the repeated uses of medical resource and how to enhance the quality of health care for the elders. Therefore, this study is to analyze and evaluate the “Medical Care Sent Home for Health and Wellbeing”which is carried out in Chiayi County for more than one year. Because “Medical Care Sent Home for Health and Wellbeing”is an innovative service, and the nurses in the public health clinics are the main care takers, and the content of the service is mainly for the follow-up treatments for the elders and chronic patients, therefore,the method for the study is to interview the enforcers of the project, namely, the public health nurses in a thorough manner, and to employ a semi-structural survey and analysis.
The researcher conducted a thorough interview from the project plan to 1. find out the relationship between the service activities and the preparation to leave the hospital, 2. conduct a discussion of the relationship between service ideas and service procedures, 3. evaluate the role and functions of a public health nurse, 4. analysis the quality of the service activities and vision of the project,in order to how well the project is carried out. Furthermore, this study is to analyze the problem faced by the public nurses when they administer the project, and put their views inductively into systematic codes so as to reach a valuable conclusion:
1. The characteristics of “Medical Care Sent Home for Health and Wellbeing”:
(1) The public health nurses can get the lists of specific cases and the data of the hospitalized, and they don’t need to screen the patients in order to reestablish the data.
(2) Focus on the elders who are not hospitalized and the preventive measures for the chronic diseases in order to raise the healing probability of these two groups so as to reduce the waste of medical resource.
(3) Be able to find out the cases under no medical care services so as to assist the disadvantageous groups and build a appropriate care taking system.
(4) The project ideals are accepted with enthusiasm by the front line enforcer, namely public health nurses.
(5) The performance of the project was deeply agreed upon and supported by the citizens of the county, and the image of the local government striving to execute its social welfare policies and taking good care of its citizens is strengthened.
(6) The role and functions of public health nurses in the project: 1.Turn passiveness to positiveness, and become a finder of a problematic case. 2.Directly understand the needs of a particular case, and become a supplier of the health care.3.Become a public health educator via this activity.4.Become a health consulter via the acquaintance of the local people through the activity.
2. There are certain suggestions of “Medical Care Sent Home for Health and Wellbeing”as follows:
(1) The accuracy of the data sent by the hospitals or the clinics should be improved in order to speed the handling the needs for the cases.
(2) The completeness of the medical history of the patients should be required in order to avoid the mistaken single illness
consideration.
(3) The difficult cases due to prolonged treatment and repeated medical care in the re-hospitalization should be resolved.
(4) The continuous education for the nurses’capability to evaluate a case, manage time and take care a chronic patient should be
enhances so as to upgrade the professionalism of public health nurses.
(5) Include the other specialists to take part in the project such as social workers, nutritionists, psychiatrists, pharmacists in order to build a comprehensive medical care system.
