愛滋病個案管理計畫效果研究

Abstract

本研究旨在探討我國「愛滋病個案管理計畫」之效果，採準實驗研究設計，選擇符合條件之愛滋病毒感染者100人作為介入組，並以配對方式選擇符合條件之愛滋病毒感染者100人作為對照組，評估兩組在醫療資源使用情形及健康狀況之差異。 本研究重要發現如下： 一、「個案管理計畫」介入後，發現介入組研究對象在「個案管理後一年CD4檢驗追蹤次數」及「CD4值提升情形」皆高於對照組，且達到統計上顯著差異，顯示個案管理在「個案管理後一年CD4檢驗追蹤次數」及「CD4值提升情形」上有效果。 二、「個案管理計畫」介入後，發現介入組研究對象在「個案管理後半年梅毒感染通報次數」低於「個案管理前半年梅毒感染通報次數」，且達到統計上顯著差異，而對照組則無，顯示個案管理在「梅毒感染通報次數」上有效果。 三、本研究中「住院天數」、「住院次數」、「住院費用」雖未產生效果，從研究對象基本資料上可知，其感染HIV迄今時間多為2-3年，在病程發展上，可能仍處於感染愛滋病毒的初期，且大多尚未診斷為愛滋病，對住院之需求較少，因此個案管理對住院之影響仍有待長時間的觀察，建議未來可進行長期追蹤住院行為，評估介入對住院之影響。The purpose of this study is to explore the effects of the HIV Case Management Program. The structure of this study employs a Quasi-experimental design. The study selects 100 eligible patients infected with HIV as the intervention group and matches them with a control group with appropriate conditions to assess the differences between the two groups in terms of medical resource utilization and patients' health status.

Major findings of this study： Ⅰ. One year after the conclusion of the Case Management Program, the intervention group exhibited a significant higher CD4 follow-up test frequency and CD4 increase than those of the control group, indicating positive effects of the aforementioned validity variables.

II. Six months after the conclusion of the Case Management Program, there was a statistically significant reduction in reports of Syphilis within the intervention group. Whereas within the control group, no significant changes in the number of reported Syphilis were observed. This demonstrates the effectiveness that case management had on the number of reported Syphilis.

III. This study did not show significant effects on the duration, frequency, and cost of hospitalization. This is likely due to the fact that the subjects of this study were within two to three years since the discovery of the infection and may still remain in the early stages of the disease. Additionally, most still were not diagnosed with AIDS and hence did not require hospitalization. Because of this, long-term study is necessary to understand the effects the Case Management Program has on hospitalization, and continued future follow-ups are recommended in order to further evaluate the program.