Purpose of the study is to find how to make decision on selecting appropriate longterm therapeutic services under a hope for meeting the expected quality and expenses of the care.
For the decision, Multi-Alternative decision making(MADM) methods and decision-making tree were applied. Health care conditional variables were analyzed by stepwise linear method to lind significantly explaining variables on therapy result variables, i. e. therapeutic quality and expenses.
The decision making procedure was tested with those targets of chronically ill patients selected by major chronic disease diagnosis among patients who had been hospitalized longer than three months. The patients were classified by three types of health care services, such as hospitalized care, home health care, and discharged care, for providing comparable data on alternative care services to hospitalized care.
Data were collected with basis of medical record, physician´s opinion, interview-questionnaire and in-depth observed findings.
Results of the MADM application shown the best therapeutic effect among patients who had surgery and hospitalized care ; and the best satisfaction status and the least expenses among patients received home health care services. When weighted the therapy results equivalent, patients in needs for internal medicine services shown the most appropriate by selecting discharged and combined with any type of therapeutic services by selecting discharged and combined with any type of therapeutic services, and the rest of patients were better when selected home health and hospitalized care services.
Decision making tree was applied to see how chronic patients would make decision on selection appropriate health services when considered his/her condition and results of the disease treatment and management. If a patient consider severity of his/her disease for the priority, he/she should take the consequences of financial burden paying for the severe disease treatment : when the patient could endure with the payment, hospitalized care is the best option. A patient who is usually maintaining good health status could expect improvement on disease manageability, therapeutic effect and saved expenses by selecting discharged care. Selection of hospitalized and home health care services would provide better access to professional health information and counseling for the disease treatment would improve the continuous disease treatment and management. A patient who has good familial environment and supports could expect improvement of his/her disease manageability for the continuous therapeutic effects. When a patient select any type of health services available without consideration of his/her condition for the disease treatment, he/she would have lee met the expected utility from consuming the services.
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