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Multidisipliner Çözümler Işığında Sağlık Yönetimi: Evde Sağlık Hizmetleri ve Fiziksel Tıp ve Rehabilitasyon

Year 2023, Volume: 14 Issue: 40, 1276 - 1289, 25.11.2023
https://doi.org/10.21076/vizyoner.1258244

Abstract

Bu çalışmanın amacı Evde Sağlık Hizmetleri (ESH) ile artan sağlık yükünü azaltmayı ve kaliteli sağlık hizmeti sunmayı hedefleyen “sağlık sistemlerinin ana kaleleri niteliğindeki sağlık tesisleri”ni nispeten rahatlatmak, sağlık hizmet sunum alanlarını değerlendirmek ve bu alanlarda uygulanabilecek yöntemler hakkında kritik yapmaktır. Multidisipliner bir yaklaşım ile Diyarbakır’da Evde Sağlık Hizmeti sunan 14 kamu hastanesine kayıtlı ESH verileri incelenmiştir. Evde sağlık hizmeti alan hastaların %53,7 (n=5009)’si kadın ve %46,3 (n=4325)’ü erkektir. Hastaların ortalama 2 tanılı ve hizmet sürelerinin ortalama 581 gün olduğu tespit edilmiştir. Örneklemin %44,03’ünün Ev Temelli Rehabilitasyon uygulamalarına aday olabileceği tespit edilmiştir. 822 günlük hizmet süresiyle Konjenital Malformasyon, Deformasyon ve Kromozom Anomalileri (Q00-Q99) ve 813 günlük hizmet süresiyle Kas-İskelet ve Bağ Dokusu Hastalıkları (M00-M99) tanılarına sahip hastaların en uzun süreyle evde sağlık hizmetleri kapsamında takip edildiği tespit edilmiştir. Fiziksel Tıp ve Rehabilitasyon uygulamalarından fayda görebilecek, sağlık tesislerine başvuru oranını düşürebilecek, hastalık yükünü hafifletecek, erken evrede hastaların sosyal yaşamlarına dönmesini hızlandırabilecek ev temelli rehabilitasyona gerek duyulmaktadır. Bu doğrultuda, Evde Rehabilitasyon (ER) uygulayabilecek özelleşmiş ekiplerin oluşturulması önerilmektedir.

Ethical Statement

Bu çalışma için Diyarbakır İl Sağlık Müdürlüğü Etik Kurulundan 97893136-38948411-900.05.01-E.176198 sayılı ve 18/11/2021 tarihli etik kurul onayı alınmıştır.

References

  • Brauner, D., Werner, R. M., Shippee, T. P., Cursio, J., Sharma, H. ve Konetzka, R. T. (2018). Does nursing home compare reflect patient safety in nursing homes? Health Affairs, 37(11), 1770-1778.
  • Brian Cassel, J., Kerr, K. M., McClish, D. K., Skoro, N., Johnson, S., Wanke, C. ve Hoefer, D. (2016). Effect of a home‐based palliative care program on healthcare use and costs. Journal of the American Geriatrics Society, 64(11), 2288-2295.
  • Chen, Y. W., Wang, C. Y., Lai, Y. H., Liao, Y. C., Wen, Y. K., Chang, S. T., ... ve Wu, T. J. (2018). Home-based cardiac rehabilitation improves quality of life, aerobic capacity, and readmission rates in patients with chronic heart failure. Medicine, 97(4).
  • Coughlin, J. F., Pope, J. E. ve Leedle Jr, B. R. (2006). Old age, new technology, and future innovations in disease management and home health care. Home Health Care Management ve Practice, 18(3), 196-207.
  • Deaver, G. G. (1919). Physical training of the wounded in Egypt. Physical Training, 16(4), 723-730.
  • DeLisa, J. A., Martin, G. A. ve Currie, D. M. (1993). Rehabilitation medicine: past, present, and future. In: DeLisa JA and Gans B, editors. Rehabilitation medicine: Principles and practice. Philadelphia: JB Lippincott Co.
  • Dostálová, V., Bártová, A., Bláhová, H. ve Holmerová, I. (2022). The experiences and needs of frail older people receiving home health care: A qualitative study. International Journal of Older People Nursing, 17(1), e12418.
  • Faronbi, J., Ajadi, A. ve Gobbens, R. (2020). Associations of chronic illnesses and socio-demographic factors with health-related quality of life of older adults in Nigeria: A cross-sectional study. Ghana Medical Journal, 54(3), 164-172.
  • Flaatten, H., De Lange, D. W., Morandi, A., Andersen, F. H., Artigas, A., Bertolini, G., ... ve VIP1 Study Group. (2017). The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (≥ 80 years). Intensive Care Medicine, 43, 1820-1828.
  • Gümüş, R. ve Sarıbaş, S. (2016). Utilization of home health care servıces provided by government among elderly individuals between 2010 and 2015 in Diyarbakır, Turkey. Turkish Journal of Geriatrics/Türk Geriatri Dergisi, 19(3).
  • Gümüş, R. ve Sarıbaş, S. (2017). Diyarbakır ili ve ilçelerinde 2015 yılında sağlık Bakanlığı’na bağlı hastanelerin sunduğu evde bakım hizmetlerinin değerlendirilmesi. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi, 3(1), 17-27.
  • Han, R. H., Schmidt, M. N., Waits, W. M., Bell, A. K. ve Miller, T. L. (2020). Planning for mental health needs during COVID-19. Current Psychiatry Reports, 22, 1-10.
  • Hotta, A. (2015). Home rehabilitation. Japan Medical Association, 1(58), 40-43.
  • Jnr, G. A. (2011). The effect of multidisciplinary team care on cancer management. Pan African Medical Journal, 9(1).
  • Koukourikos, K., Georgopoulou, A., Kourkouta, L. ve Tsaloglidou, A. (2019). Benefits of animal assisted therapy in mental health. International Journal of Caring Sciences, 12(3), 1898-1905.
  • Kurt, M. E., Çemberlitaş, İ. ve Şen, M. A. (2019). Evde sağlık hizmetleri birimi tarafından sunulan hizmetlerin sosyal devlet olma ilkesi açısından incelenmesi. Dicle Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 9(18), 306-318.
  • Leonardi, M. ve Fheodoroff, K. (2021). Goal setting with ICF (International Classification of Functioning, Disability and Health) and multidisciplinary team approach in stroke rehabilitation. Clinical Pathways in Stroke Rehabilitation: Evidence-based Clinical Practice Recommendations, 35-56.
  • Lonsdale, C., Hall, A. M., Murray, A., Williams, G. C., McDonough, S. M., Ntoumanis, N., ... ve Hurley, D. A. (2017). Communication skills training for practitioners to increase patient adherence to home-based rehabilitation for chronic low back pain: results of a cluster randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 98(9), 1732-1743.
  • López-Liria, R., Padilla-Góngora, D., Catalan-Matamoros, D., Rocamora-Pérez, P., Pérez-de la Cruz, S. ve Fernández-Sánchez, M. (2015). Home-based versus hospital-based rehabilitation program after total knee replacement. BioMed Research International, 2015.
  • Martínez Ríos, I., López Alonso, S. R., Martín Caravante, S., Morales Infante, L., Soriano Ruiz, S. I. ve Martínez García, A. I. (2018). Prevalencia y tipología de pacientes susceptibles de cuidados paliativos fallecidos en el domicilio. In Anales del Sistema Sanitario de Navarra 41 (3), 321-328).
  • Martínez, F. M., Farré, G. F., ve Andreu, E. L. (Eds.). (2014). Rehabilitación domiciliaria: Principios, indicaciones y programas terapéuticos. Elsevier España.
  • Patel, A. A., Woodrell, C., Ufere, N. N., Hansen, L., Tandon, P., Verma, M., ... ve Palliative Care Education, Advocacy, and Research in Liver Disease (PEARL) Workgroup and the AASLD Public Health/Healthcare Delivery Special Interest Group (SIG). (2021). Developing priorities for palliative care research in advanced liver disease: a multidisciplinary approach. Hepatology Communications, 5(9), 1469-1480.
  • Piotrowicz, E., Baranowski, R., Bilinska, M., Stepnowska, M., Piotrowska, M., Wójcik, A., ... ve Piotrowicz, R. (2010). A new model of home‐based telemonitored cardiac rehabilitation in patients with heart failure: effectiveness, quality of life, and adherence. European journal of heart failure, 12(2), 164-171.
  • Riffin, C., Van Ness, P. H., Wolff, J. L. ve Fried, T. (2019). Multifactorial examination of caregiver burden in a national sample of family and unpaid caregivers. Journal of the American Geriatrics Society, 67(2), 277-283.
  • Sağlık Bakanlığı Kamu Hastaneleri Genel Müdürlüğü. (2022). Evde sağlık hizmeti erişim. https://khgmozellikli.saglik.gov.tr/svg/evde.php adresinden 11 Ocak 2022 tarihinde alınmıştır.
  • Sağlık Bakanlığı. (2015). Sağlık Bakanlığı ve bağlı kuruluşları tarafından evde sağlık hizmetlerinin sunulmasına dair yönetmelik. https://www.resmigazete.gov.tr/eskiler/2015/02/20150227-14.htm adresinden 25 Mayıs 2022 tarihinde alınmıştır.
  • Sheehy, L., Taillon-Hobson, A., Sveistrup, H., Bilodeau, M., Yang, C., Welch, V., ... ve Finestone, H. (2019). Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: A parallel randomized feasibility trial. Trials, 20(1), 1-9.
  • Smith, J. M., Lee, A. C., Zeleznik, H., Coffey Scott, J. P., Fatima, A., Needham, D. M. ve Ohtake, P. J. (2020). Home and community-based physical therapist management of adults with post–intensive care syndrome. Physical Therapy, 100(7), 1062-1073.
  • Stavarache, I. E., Buculei, I., Cernomaz, A., Vicol, C., Dabija, R. A. C. ve Trofor, A. C. (2022). Role of pulmonary rehabilitation in chronic obstructive pulmonary disease - a historical perspective. Medicine and Pharmacy Reports, 95(4), 475–485.
  • Türkiye Rehberi. (2022). Diyarbakır Haritası. https://www.turkiye-rehberi.net/diyarbakir-haritasi.asp adresinden 4 Haziran 2022 tarihinde alınmıştır.
  • Vega-Ramírez, F. A., López-Liria, R., Granados-Gámez, G., Aguilar-Parra, J. M. ve Padilla-Góngora, D. (2017). Analysis of home-based rehabilitation in patients with motor impairment in primary care: A prospective observational study. BMC Geriatrics, 17(1), 1-8.
  • Verhaegh, K. J., MacNeil-Vroomen, J. L., Eslami, S., Geerlings, S. E., de Rooij, S. E. ve Buurman, B. M. (2014). Transitional care interventions prevent hospital readmissions for adults with chronic illnesses. Health affairs, 33(9), 1531-1539.
  • WHO. (2017). Europe Home Care in Europe Report. https://www.euro.who.int/__data/assets/pdf_file/0005/96467/E91884.pdf adresinden 12 Mart 2023 tarihinde alınmıştır.
  • WHO. (2019). World population ageing. https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf adresinden 12 Mart 2023 tarihinde alınmıştır.
  • World Health Organization. Regional Office for the Eastern Mediterranean. (‎2015)‎. The growing need for home health care for the elderly: home health care for the elderly as an integral part of primary health care services. World Health Organization. Regional Office for the Eastern Mediterranean.
  • Wu, D., Zhu, X. ve Zhang, S. (2018). Effect of home-based rehabilitation for hip fracture: A meta-analysis of randomized controlled trials. Journal of rehabilitation medicine, 50(6), 481-486.

Health Management in the Light of Multidisciplinary Solutions: Home Health Care and Physical Medicine and Rehabilitation

Year 2023, Volume: 14 Issue: 40, 1276 - 1289, 25.11.2023
https://doi.org/10.21076/vizyoner.1258244

Abstract

The study aims to relieve the health facilities that aim to reduce the increasing health burden and provide quality health services with Home Health Services (ESH), evaluate the service delivery areas and make critical about the methods that can be applied in these areas. ESH data registered in 14 public hospitals providing Home Health Services in Diyarbakır are examined. 53.7% (n=5009) of the patients are female, and 46.3% (n=4325) are male. It is determined that the patients are diagnosed with an average of 2 diagnoses, and the average length of service is 581 days and 44.03% of the sample can be candidates for Home Based Rehabilitation applications. It is determined that the patients diagnosed with Congenital Malformation, Deformation and Chromosomal Anomalies (Q00-Q99) with a service period of 822 days and Musculoskeletal and Connective Tissue Diseases with a service period of 813 days (M00-M99) are followed for the longest time within the scope of home health services. There is a need for home-based rehabilitation that can reduce the rate of admission to health facilities, alleviate the burden of disease, and accelerate the return of patients to their social lives at an early stage. In this direction, it is recommended to establish specialized teams that can implement Rehabilitation at Home (ER).

Ethical Statement

Bu çalışma için Diyarbakır İl Sağlık Müdürlüğü Etik Kurulundan 97893136-38948411-900.05.01-E.176198 sayılı ve 18/11/2021 tarihli etik kurul onayı alınmıştır.

References

  • Brauner, D., Werner, R. M., Shippee, T. P., Cursio, J., Sharma, H. ve Konetzka, R. T. (2018). Does nursing home compare reflect patient safety in nursing homes? Health Affairs, 37(11), 1770-1778.
  • Brian Cassel, J., Kerr, K. M., McClish, D. K., Skoro, N., Johnson, S., Wanke, C. ve Hoefer, D. (2016). Effect of a home‐based palliative care program on healthcare use and costs. Journal of the American Geriatrics Society, 64(11), 2288-2295.
  • Chen, Y. W., Wang, C. Y., Lai, Y. H., Liao, Y. C., Wen, Y. K., Chang, S. T., ... ve Wu, T. J. (2018). Home-based cardiac rehabilitation improves quality of life, aerobic capacity, and readmission rates in patients with chronic heart failure. Medicine, 97(4).
  • Coughlin, J. F., Pope, J. E. ve Leedle Jr, B. R. (2006). Old age, new technology, and future innovations in disease management and home health care. Home Health Care Management ve Practice, 18(3), 196-207.
  • Deaver, G. G. (1919). Physical training of the wounded in Egypt. Physical Training, 16(4), 723-730.
  • DeLisa, J. A., Martin, G. A. ve Currie, D. M. (1993). Rehabilitation medicine: past, present, and future. In: DeLisa JA and Gans B, editors. Rehabilitation medicine: Principles and practice. Philadelphia: JB Lippincott Co.
  • Dostálová, V., Bártová, A., Bláhová, H. ve Holmerová, I. (2022). The experiences and needs of frail older people receiving home health care: A qualitative study. International Journal of Older People Nursing, 17(1), e12418.
  • Faronbi, J., Ajadi, A. ve Gobbens, R. (2020). Associations of chronic illnesses and socio-demographic factors with health-related quality of life of older adults in Nigeria: A cross-sectional study. Ghana Medical Journal, 54(3), 164-172.
  • Flaatten, H., De Lange, D. W., Morandi, A., Andersen, F. H., Artigas, A., Bertolini, G., ... ve VIP1 Study Group. (2017). The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (≥ 80 years). Intensive Care Medicine, 43, 1820-1828.
  • Gümüş, R. ve Sarıbaş, S. (2016). Utilization of home health care servıces provided by government among elderly individuals between 2010 and 2015 in Diyarbakır, Turkey. Turkish Journal of Geriatrics/Türk Geriatri Dergisi, 19(3).
  • Gümüş, R. ve Sarıbaş, S. (2017). Diyarbakır ili ve ilçelerinde 2015 yılında sağlık Bakanlığı’na bağlı hastanelerin sunduğu evde bakım hizmetlerinin değerlendirilmesi. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi, 3(1), 17-27.
  • Han, R. H., Schmidt, M. N., Waits, W. M., Bell, A. K. ve Miller, T. L. (2020). Planning for mental health needs during COVID-19. Current Psychiatry Reports, 22, 1-10.
  • Hotta, A. (2015). Home rehabilitation. Japan Medical Association, 1(58), 40-43.
  • Jnr, G. A. (2011). The effect of multidisciplinary team care on cancer management. Pan African Medical Journal, 9(1).
  • Koukourikos, K., Georgopoulou, A., Kourkouta, L. ve Tsaloglidou, A. (2019). Benefits of animal assisted therapy in mental health. International Journal of Caring Sciences, 12(3), 1898-1905.
  • Kurt, M. E., Çemberlitaş, İ. ve Şen, M. A. (2019). Evde sağlık hizmetleri birimi tarafından sunulan hizmetlerin sosyal devlet olma ilkesi açısından incelenmesi. Dicle Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 9(18), 306-318.
  • Leonardi, M. ve Fheodoroff, K. (2021). Goal setting with ICF (International Classification of Functioning, Disability and Health) and multidisciplinary team approach in stroke rehabilitation. Clinical Pathways in Stroke Rehabilitation: Evidence-based Clinical Practice Recommendations, 35-56.
  • Lonsdale, C., Hall, A. M., Murray, A., Williams, G. C., McDonough, S. M., Ntoumanis, N., ... ve Hurley, D. A. (2017). Communication skills training for practitioners to increase patient adherence to home-based rehabilitation for chronic low back pain: results of a cluster randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 98(9), 1732-1743.
  • López-Liria, R., Padilla-Góngora, D., Catalan-Matamoros, D., Rocamora-Pérez, P., Pérez-de la Cruz, S. ve Fernández-Sánchez, M. (2015). Home-based versus hospital-based rehabilitation program after total knee replacement. BioMed Research International, 2015.
  • Martínez Ríos, I., López Alonso, S. R., Martín Caravante, S., Morales Infante, L., Soriano Ruiz, S. I. ve Martínez García, A. I. (2018). Prevalencia y tipología de pacientes susceptibles de cuidados paliativos fallecidos en el domicilio. In Anales del Sistema Sanitario de Navarra 41 (3), 321-328).
  • Martínez, F. M., Farré, G. F., ve Andreu, E. L. (Eds.). (2014). Rehabilitación domiciliaria: Principios, indicaciones y programas terapéuticos. Elsevier España.
  • Patel, A. A., Woodrell, C., Ufere, N. N., Hansen, L., Tandon, P., Verma, M., ... ve Palliative Care Education, Advocacy, and Research in Liver Disease (PEARL) Workgroup and the AASLD Public Health/Healthcare Delivery Special Interest Group (SIG). (2021). Developing priorities for palliative care research in advanced liver disease: a multidisciplinary approach. Hepatology Communications, 5(9), 1469-1480.
  • Piotrowicz, E., Baranowski, R., Bilinska, M., Stepnowska, M., Piotrowska, M., Wójcik, A., ... ve Piotrowicz, R. (2010). A new model of home‐based telemonitored cardiac rehabilitation in patients with heart failure: effectiveness, quality of life, and adherence. European journal of heart failure, 12(2), 164-171.
  • Riffin, C., Van Ness, P. H., Wolff, J. L. ve Fried, T. (2019). Multifactorial examination of caregiver burden in a national sample of family and unpaid caregivers. Journal of the American Geriatrics Society, 67(2), 277-283.
  • Sağlık Bakanlığı Kamu Hastaneleri Genel Müdürlüğü. (2022). Evde sağlık hizmeti erişim. https://khgmozellikli.saglik.gov.tr/svg/evde.php adresinden 11 Ocak 2022 tarihinde alınmıştır.
  • Sağlık Bakanlığı. (2015). Sağlık Bakanlığı ve bağlı kuruluşları tarafından evde sağlık hizmetlerinin sunulmasına dair yönetmelik. https://www.resmigazete.gov.tr/eskiler/2015/02/20150227-14.htm adresinden 25 Mayıs 2022 tarihinde alınmıştır.
  • Sheehy, L., Taillon-Hobson, A., Sveistrup, H., Bilodeau, M., Yang, C., Welch, V., ... ve Finestone, H. (2019). Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: A parallel randomized feasibility trial. Trials, 20(1), 1-9.
  • Smith, J. M., Lee, A. C., Zeleznik, H., Coffey Scott, J. P., Fatima, A., Needham, D. M. ve Ohtake, P. J. (2020). Home and community-based physical therapist management of adults with post–intensive care syndrome. Physical Therapy, 100(7), 1062-1073.
  • Stavarache, I. E., Buculei, I., Cernomaz, A., Vicol, C., Dabija, R. A. C. ve Trofor, A. C. (2022). Role of pulmonary rehabilitation in chronic obstructive pulmonary disease - a historical perspective. Medicine and Pharmacy Reports, 95(4), 475–485.
  • Türkiye Rehberi. (2022). Diyarbakır Haritası. https://www.turkiye-rehberi.net/diyarbakir-haritasi.asp adresinden 4 Haziran 2022 tarihinde alınmıştır.
  • Vega-Ramírez, F. A., López-Liria, R., Granados-Gámez, G., Aguilar-Parra, J. M. ve Padilla-Góngora, D. (2017). Analysis of home-based rehabilitation in patients with motor impairment in primary care: A prospective observational study. BMC Geriatrics, 17(1), 1-8.
  • Verhaegh, K. J., MacNeil-Vroomen, J. L., Eslami, S., Geerlings, S. E., de Rooij, S. E. ve Buurman, B. M. (2014). Transitional care interventions prevent hospital readmissions for adults with chronic illnesses. Health affairs, 33(9), 1531-1539.
  • WHO. (2017). Europe Home Care in Europe Report. https://www.euro.who.int/__data/assets/pdf_file/0005/96467/E91884.pdf adresinden 12 Mart 2023 tarihinde alınmıştır.
  • WHO. (2019). World population ageing. https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf adresinden 12 Mart 2023 tarihinde alınmıştır.
  • World Health Organization. Regional Office for the Eastern Mediterranean. (‎2015)‎. The growing need for home health care for the elderly: home health care for the elderly as an integral part of primary health care services. World Health Organization. Regional Office for the Eastern Mediterranean.
  • Wu, D., Zhu, X. ve Zhang, S. (2018). Effect of home-based rehabilitation for hip fracture: A meta-analysis of randomized controlled trials. Journal of rehabilitation medicine, 50(6), 481-486.
There are 36 citations in total.

Details

Primary Language Turkish
Subjects Health Policy
Journal Section Research Articles
Authors

Askeri Turken 0000-0003-0638-8918

Mehmet Emin Kurt 0000-0002-7181-8681

Mehmet Aziz Çakmak 0000-0002-5040-5642

Cuma Çakmak 0000-0002-4409-9669

Publication Date November 25, 2023
Submission Date March 1, 2023
Published in Issue Year 2023 Volume: 14 Issue: 40

Cite

APA Turken, A., Kurt, M. E., Çakmak, M. A., Çakmak, C. (2023). Multidisipliner Çözümler Işığında Sağlık Yönetimi: Evde Sağlık Hizmetleri ve Fiziksel Tıp ve Rehabilitasyon. Süleyman Demirel Üniversitesi Vizyoner Dergisi, 14(40), 1276-1289. https://doi.org/10.21076/vizyoner.1258244

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