介護保険利用者家族によるケアマネジメントの評価

　本研究の目的は, 介護保険における家族ニーズの視点から家族を含むケアマネジメントの実態を把握し, その評価を行うことである｡調査対象者は, 平成12年度に介護保険による在宅サービスを６か月以上使用した利用者628人とそのケアマネジャーである｡利用者とケアマネジャーにケアマネジメントの評価について答える調査票を作成し, 無記名郵送法によるアンケート調査を行った｡回収は利用者389人, ケアマネジャー503人からあり, 利用者とケアマネジャーの調査票が一致したのは331人で, このうち分析対象者は家族による回答の207人である｡結果は, 現在のサービス以外に必要なサービスがあると回答した家族は61人(32.3％),ケアマネジャーは101人(49.3％)であった｡家族とケアマネジャーがともにあると回答したのは35人で, 家族ニーズとケアマネジャーの判断にはずれがあった｡サービス全般に満足しているという主観的満足度に対し満足と答えた家族は78.2％であった｡主観的満足度を高める要因は, サービスの種類や回数, 礼儀や思いやりのある態度, 利用料の適切性といった利用条件と, 自宅に近いといった選択理由であった｡以上より, 家族がニーズに合ったサービスを利用し, サービスへの満足感を高めていけるケアマネジメントの重要性と, ケアマネジメント技術の向上を図る必要性が示唆された｡
　The purpose of this study was to clanfy and evaluate the practice of care management and family conditions from a viewpoint of family needs in the long-term care　insurance. Subjects were 628 users who used home care services under the long-term care insurance for more than 6 months in 2000, and their care managers. We developed a questionnaire to evaluate care management by users and care managers, and conducted a survey by using an unidentified mailing method. We received 389 replies from users and 503 replies from eare managers. Of these, we analyzed 207 farnily replies which were
matched with those of their care managers.
　As a result, 61 families (32.3%) and 101 care managers (49.3%) reported that more services other than the present services. 35 replies were consistent between the families and care managers the necessary services, thus there was a discrepancy between the family needs and the judgment of care managers. For subjective satisfaction, 78.2% of the families were satisfied with the overall services. As
factors for higher subjective satisfaction, there were kinds and frequency of services, manner and thoughtfulness attitude, conditions including appropriate fee, and reasons for using services such as close to home. These results of the study suggest that care management system needs to provide services to meet the family needs and to irnprove family satisfaction, and technical improvement of care management.