Using case-based reasoning to establish a continuing care information system of discharge planning

As family structure changes, population is aging and disease styles tend to be chronic, long-term care in Taiwan becomes problematic, needs to be addressed, and requires immediate solution. Presently, many medical care institutions in the country have assisted patients in discharge planning; however, the lack of a standard evaluation procedure in the process of discharge planning is disturbing for each hospital. Without it, there might be huge differences in the evaluation results. Moreover, the lack of support and the uncertainty of case eligibility standard in these institutions further affect the performance of continuing care services. This research adopted Case-Based Reasoning to establish a continuing care information system of discharge planning. With previously evaluated information of past cases, the similarity index is compared among new cases. In coordinate with Analytic Hierarchy Process. index weight is calculated to reason an old case that is most closely related to the condition of the new case. This information system can assist discharge-planning staff in accurately formulating a plan of action based on previous case-assessment experience and in obtaining valuable information that helps make decision. Through the implementation of the system, accumulation on knowledge and experience of continuing care models will help staff evaluate process of discharge planning to achieve a reasonable, standardized, and simplified procedure as a whole. This research will transform the evaluating experience of discharge-planning professionals into ail assessment method with the application of computer reasoning to make the evaluation process of discharge planning convenient as well as to save more time for discharge-planning professionals to further understand the actual conditions of each case. On the other hand, this information system will provide discharge-planning staff with a set of recommendations as references for making individual discharge plan. It is expected through this research that each hospital be provided with a blue print of improvement in case evaluation process and management. (C) 2004 Elsevier Ltd. All rights reserved.