臺灣長期照顧實作指引(TW LTC IG), published by 經濟部產業發展署. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Lorex/TWLongTermCare_IG_Build/ and changes regularly. See the Directory of published versions
Questionnaire: 居家護理－個案基本資料問卷
| Official URL: http://ltc-ig.fhir.tw/Questionnaire/hn-basedata | Version: 1.1.0 | |||
| Draft as of 2025-12-08 | Computable Name: HNBaseDataQuestionnaire | |||
V5.0.16 個案基本資料的問題結構與輸入型態。
Profile: 長期照顧－問卷
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  HNBaseDataQuestionnaire | V5.0.16 個案基本資料的問題結構與輸入型態。 | Questionnaire | http://ltc-ig.fhir.tw/Questionnaire/hn-basedata#1.1.0 | |
  CaseID | 個案身分證字號 | 1..1 | string | Max Length: 10 Value Set: |
 EndDate | 收案日期 | 1..1 | date | Value Set: |
  CaseSource | 收案來源 | 1..1 | group | Value Set: |
  CaseSource.Value | 選項 | 1..1 | choice | Value Set: 居家護理－收案來源選項 |
 CaseSource.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| CaseName | 個案姓名 | 1..1 | string | Max Length: 50 Value Set: |
| Sex | 性別 | 1..1 | group | Value Set: |
| Sex.Value | 選項 | 1..1 | choice | Value Set: 居家護理－性別選項 |
| Sex.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| CaseType | 個案類型 | 1..1 | choice | Value Set: 居家護理－個案類型選項 |
| Birthdate | 出生日期 | 1..1 | date | Value Set: |
| PhoneNumber | 聯絡電話 | 1..1 | string | Max Length: 30 Value Set: |
| Address | 居住地址 | 1..1 | group | Value Set: |
| Address.City | 縣市 | 1..1 | string | Max Length: 100 Value Set: |
| Address.Area | 鄉鎮市區 | 1..1 | string | Max Length: 100 Value Set: |
| Address.Lane | 街路門牌 | 1..1 | string | Max Length: 100 Value Set: |
| Education | 教育程度 | 1..1 | group | Value Set: |
| Education.Value | 選項 | 1..1 | choice | Value Set: 居家護理－教育程度選項 |
| Education.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| Marriage | 婚姻狀況 | 1..1 | group | Value Set: |
| Marriage.Value | 選項 | 1..1 | choice | Value Set: 居家護理－婚姻狀況選項 |
| Marriage.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| Religion | 宗教信仰 | 1..1 | group | Value Set: |
| Religion.Value | 選項 | 1..1 | choice | Value Set: 居家護理－宗教信仰選項 |
| Religion.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| ExJob | 主要職業 | 1..1 | group | Value Set: |
| ExJob.Value | 選項 | 1..1 | choice | Value Set: 居家護理－主要職業選項 |
| ExJob.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| Economic | 家庭經濟狀況 | 1..1 | group | Value Set: |
| Economic.Value | 選項 | 1..1 | choice | Value Set: 居家護理－家庭經濟狀況選項 |
| Economic.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| HasWelfare | 是否有福利 | 1..1 | choice | Value Set: 居家護理－有無選項 |
| Welfare | 福利種類 | 0..1 | group | Value Set: |
| Welfare.Values | 選項 | 0..* | choice | Value Set: 居家護理－福利種類多選選項 |
| Welfare.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| Welfare.DisabilityType | 身障類別 | 0..1 | choice | Value Set: 居家護理－身障類別 |
| CaregiverID | 主要照顧者關係 | 1..1 | choice | Value Set: 居家護理－主要照顧者關係選項 |
| CaregiverName | 主要照顧者姓名 | 1..1 | string | Max Length: 50 Value Set: |
| CaregiverAddress | 主要照顧者地址 | 1..1 | group | Value Set: |
| CaregiverAddress.City | 縣市 | 1..1 | string | Max Length: 100 Value Set: |
| CaregiverAddress.Area | 鄉鎮市區 | 1..1 | string | Max Length: 100 Value Set: |
| CaregiverAddress.Lane | 街路門牌 | 1..1 | string | Max Length: 100 Value Set: |
| CaregiverTel | 主要照顧者電話 | 1..1 | string | Max Length: 20 Value Set: |
| EgyContactRelation | 緊急聯絡人關係 | 1..1 | choice | Value Set: 居家護理－緊急聯絡人關係選項 |
| EgyContactName | 緊急聯絡人姓名 | 1..1 | string | Max Length: 50 Value Set: |
| EgyContactTel1 | 緊急聯絡電話一 | 1..1 | string | Max Length: 30 Value Set: |
| EgyContactTel2 | 緊急聯絡電話二 | 0..1 | string | Max Length: 30 Value Set: |
| NurseID | 主責護理人員身分證字號 | 1..1 | string | Max Length: 10 Value Set: |
| DecisionMakerRelation | 主要醫療決定者關係 | 1..1 | group | Value Set: |
| DecisionMakerRelation.Value | 選項 | 1..1 | choice | Value Set: 居家護理－主要醫療決定者關係選項 |
| DecisionMakerRelation.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| MEvent | 一年內是否發生重大事件 | 1..1 | choice | Value Set: 居家護理－有無選項 |
| MEventItem | 重大事件項目 | 0..1 | group | Value Set: |
| MEventItem.Values | 選項 | 0..* | choice | Value Set: 居家護理－重大事件項目多選選項 |
| MEventItem.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| CaseDesc | 個案描述 | 0..1 | string | Max Length: 1000 Value Set: |
| CreateID | 建立機構代碼 | 1..1 | string | Max Length: 10 Value Set: |
| Medicals | 共照醫事人員 | 0..* | group | Value Set: |
| Medicals.Name | 成員姓名 | 1..1 | string | Max Length: 50 Value Set: |
| Medicals.CareDate | 加入日期 | 0..1 | date | Value Set: |
| Medicals.IdNo | 成員身分證字號 | 0..1 | string | Max Length: 10 Value Set: |
| Medicals.JobTitle | 成員職稱 | 1..1 | group | Value Set: |
| Medicals.JobTitle.Value | 選項 | 1..1 | choice | Value Set: 居家護理－成員職稱選項 |
| Medicals.JobTitle.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| Medicals.Tel | 電話 | 1..1 | string | Max Length: 30 Value Set: |
| Medicals.CareRemark | 照護備註 | 0..1 | string | Max Length: 1000 Value Set: |
 Relatives | 共照親友 | 0..* | group | Value Set: |
 Relatives.Name | 成員姓名 | 1..1 | string | Max Length: 50 Value Set: |
| Relatives.Relationship | 關係 | 1..1 | group | Value Set: |
| Relatives.Relationship.Value | 選項 | 1..1 | choice | Value Set: 居家護理－關係選項 |
| Relatives.Relationship.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| Relatives.CareTime | 主要照顧時間 | 1..1 | group | Value Set: |
| Relatives.CareTime.Value | 選項 | 1..1 | choice | Value Set: 居家護理－主要照顧時間選項 |
| Relatives.CareTime.Other | 補充說明 | 0..1 | string | Max Length: 100 Value Set: |
| Relatives.Tel1 | 電話1 | 1..1 | group | Value Set: |
| Relatives.Tel1.Value | 電話號碼 | 1..1 | string | Max Length: 30 Value Set: |
| Relatives.Tel1.Remark | 聯絡時間與說明 | 0..1 | string | Max Length: 100 Value Set: |
| Relatives.Tel2 | 電話2 | 0..1 | group | Value Set: |
| Relatives.Tel2.Value | 電話號碼 | 1..1 | string | Max Length: 30 Value Set: |
| Relatives.Tel2.Remark | 聯絡時間與說明 | 0..1 | string | Max Length: 100 Value Set: |
| Relatives.Tel3 | 電話3 | 0..1 | group | Value Set: |
| Relatives.Tel3.Value | 電話號碼 | 1..1 | string | Max Length: 30 Value Set: |
| Relatives.Tel3.Remark | 聯絡時間與說明 | 0..1 | string | Max Length: 100 Value Set: |
| Relatives.CareRemark | 照護備註 | 0..1 | string | Max Length: 1000 Value Set: |
| Documentation for this format | ||||