台灣地區老年人口占總人口比率之10.4％，每五位老年人當中，每年至少有一位發生跌倒意外。老年人口之跌倒預防一直是全球老人保健之重要議題。跌倒預防門診為跌倒預防措施常見的方法之一，運用周全性評估與整合性多重因子介入措施，以有效防範社區老人跌倒之發生。國立成功大學醫學院附設醫院自民國97年5月成立跨科部老人跌倒預防團隊並試辦跌倒預防門診，目前已服務73位病人，本研究目的即在瞭解該項服務之成效，並做為進一步改進之參考。本研究運用Donabedian所提出的健康照護品質架構針對門診醫療模式進行評值。研究對象包含門診團隊成員與在本門診看診滿六個月以上之病人或其家屬，針對本門診之結構、過程、結果面進行評值。
結果顯示，本門診團隊涵蓋多學科成員且具有周全的評估模式。給予病人的建議種類中，以運動建議比率最高。病人參與跌倒預防門診後其跌倒次數、跌倒傷害次數其呈現改善趨勢；起走測試呈顯著改善；日常生活活動功能呈現顯著下降；跌倒害怕程度、單腳站立平衡、前伸測試、下肢肌力則無顯著差異。依其遵從性來看，運動、藥物、環境建議多數無法遵從，整體之遵從性尚須加強。本門診之病人與照顧者對跌倒相關已有部分基礎之了解，但於跌倒預防行為之執行上尚有落差。整體而言，對門診之滿意度為滿意。此研究結果可提供老人跌倒醫療照護與防治之參考。

The elderly in Taiwan accounts for 10.4% of the total population. Annually, one fifth of all elderly will experience a fall accident. Fall prevention in the elderly is an important global issue in field of geriatric health care. Establishing falls clinic is one of the common approaches to prevent fall in community elders. The falls clinic, which is a multidisciplinary fall-prevention program in the National Cheng Kung University Hospital, was setup on May, 2008. Currently, the clinic has served 73 patients. The study utilized the health care quality structure developed by Donabedian to assess the quality of medical care and to examine the effectiveness of the clinic in fall prevention. The purpose of the study allows a greater understanding regarding the program outcomes. Study participants included team members from the falls clinic and outpatients who have had at least a six month follow-up.
The result shows that the clinic has members from multidisciplinary fields and has a complete assessment model. The most frequent suggestion given to patients was recommending them to exercise. After patients participated in the clinic, improvements were observed in falls, fall injuries and the Time up and go test, but the activities of daily living decline. Others measurements have no significant difference, such as fear of falling, one-leg standing test, forward reach test and leg muscle strength. According to the adherence, exercise, medicine, and environment were less adhered. In order to improve adherence, multifactorial fall prevention interventions need to adjust for suitableness. Patients and caregivers understand a majority of the fall-related knowledge, but fall-prevention efforts were not fully executed, and improvement is needed. As a whole, the degree of clinic satisfaction is satisfactory. The study results can serve as a reference for further improvements in geriatric health care services.

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