{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T06:31:25Z","timestamp":1762065085531,"version":"build-2065373602"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T00:00:00Z","timestamp":1662681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Yang-Ming University Hospita","award":["project No: RD2017-009"],"award-info":[{"award-number":["project No: RD2017-009"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Aims<\/jats:title><jats:p>The number of ventilator-dependent patients is rapidly increasing globally. As a result, long-term mechanical ventilation (LTMV) patients face the choice of receiving health care in respiratory care wards (RCWs) rather than at home. In this study, we applied Andersen\u2019s behavioral theoretical model (ABM) to investigate the determinants of the health care service decisions of patients receiving LTMV.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>A cross-sectional research design and cluster random sampling were used to select 365 participants from nine RCWs and eight home care facilities in northern Taiwan. Data were collected in face-to-face interviews using a structured questionnaire.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Of the predisposing factors, advanced age and an education level of at least junior high school influenced the choice to use RCW services. Being married, living with extended family, and medium or higher socioeconomic status were associated with the decision to use home care services. Of the enabling factors, patients with more caregivers, those whose family caregivers held strong beliefs about providing care, and those who perceived greater social support from health care providers were more likely to choose home care services. Of the need factors examined, poor cognitive function and higher dependence on assistance for activities of daily living (ADL) increased the probability of patients choosing RCW services. Hierarchical logistic regression analysis indicated that our final model accounted for 44.8% of the observed variance in health care service choice.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>ABM enables an improved understanding of the health care service choices of LTMV patients. Our findings also highlight the importance of rigorously assessing patient needs and helping patients choose the most appropriate health care service.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0274303","type":"journal-article","created":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T19:56:24Z","timestamp":1662753384000},"page":"e0274303","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Determinants of the health care service choices of long-term mechanical ventilation patients: Applying andersen\u2019s behavioral model"],"prefix":"10.1371","volume":"17","author":[{"given":"Hui-Yu","family":"Liang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Der","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuan-Chia","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lieh-Hann","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2449-9152","authenticated-orcid":true,"given":"Shu","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,9,9]]},"reference":[{"issue":"2","key":"pone.0274303.ref001","doi-asserted-by":"crossref","first-page":"R102","DOI":"10.1186\/cc10117","article-title":"Prolonged mechanical ventilation in critically ill patients: epidemiology, outcomes and modelling the potential cost consequences of establishing a regional weaning unit","volume":"15","author":"NI Lone","year":"2011","journal-title":"Critical Care"},{"issue":"3","key":"pone.0274303.ref002","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1513\/AnnalsATS.201610-792OC","article-title":"Long-Term outcomes and health care utilization after prolonged mechanical ventilation","volume":"14","author":"AD Hill","year":"2017","journal-title":"Ann Am Thorac Soc"},{"issue":"6","key":"pone.0274303.ref003","doi-asserted-by":"crossref","first-page":"848","DOI":"10.4187\/respcare.01736","article-title":"Definitions and epidemiology of the chronically critically ill","volume":"57","author":"SS Carson","year":"2012","journal-title":"Respir Care"},{"issue":"12","key":"pone.0274303.ref004","first-page":"1693","article-title":"Prolonged mechanical ventilation in Massachusetts: the 2006 prevalence survey","volume":"55","author":"MJ Divo","year":"2010","journal-title":"Respir Care"},{"issue":"1","key":"pone.0274303.ref005","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1097\/CCM.0b013e31822e9ffd","article-title":"Accuracy of previous estimates for adult prolonged acute mechanical ventilation volume in 2020: update using 2000\u20132008 data","volume":"40","author":"MD Zilberberg","year":"2012","journal-title":"Crit Care Med"},{"issue":"3","key":"pone.0274303.ref006","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1097\/CCM.0B013E31816536F7","article-title":"Prolonged acute mechanical ventilation, hospital resource utilization, and mortality in the United States","volume":"36","author":"MD Zilberberg","year":"2008","journal-title":"Crit Care Med"},{"issue":"1","key":"pone.0274303.ref007","first-page":"25","article-title":"The current status of health delivery system and quality of care for patients with long-term mechanical ventilation in Taiwan","volume":"11","author":"YC Ku SC","year":"2010","journal-title":"Crit Care Med"},{"key":"pone.0274303.ref008","unstructured":"National Health Insurance Administration Ministry of Health and Welfare. 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