FHIR IG analytics| Package | tw.iii.ltc |
| Resource Type | Questionnaire |
| Id | Questionnaire-questionnaire-aa02-example.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/Lorex/TWLongTermCare_IG_Build/Questionnaire-questionnaire-aa02-example.html |
| URL | http://ltc-ig.fhir.tw/Questionnaire/questionnaire-aa02-example |
| Version | 1.0.0 |
| Status | active |
| Date | 2026-04-03T13:32:05+00:00 |
| Name | AA02 |
| Title | 照顧管理問卷 (AA02) |
| Realm | tw |
| Description | 依 AA02 追蹤服務適應與介入、各項服務使用情形、計畫適切性與需求異動、其他處理事項之書寫範例而設計。 |
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Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire questionnaire-aa02-example
Profile: 長期照顧－問卷
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  AA02 | 依 AA02 追蹤服務適應與介入、各項服務使用情形、計畫適切性與需求異動、其他處理事項之書寫範例而設計。 | Questionnaire | http://ltc-ig.fhir.tw/Questionnaire/questionnaire-aa02-example#1.0.0 | |
  serviceAdaptation | 追蹤服務適應與介入情形 | 1..1 | group | |
  contactTime | 聯繫時間 | 1..1 | dateTime | |
  contactTarget | 電訪對象 | 0..* | string | |
| approvedServices | 核定服務類別及頻率（填入最新一筆計劃核定碼別及各碼別適應情形） | 0..1 | group | |
 homeServicePlan | 居家服務（應填寫碼別與服務單位） | 0..* | text | |
| transportationPlan | 交通服務（金額/頻率/使用規劃） | 0..1 | text | |
| professionalServicePlan | 專業服務（代碼/目標/對象/時間） | 0..1 | text | |
| respitePlan | 喘息服務 | 0..1 | text | |
| assistiveDevicesPlan | 輔具服務（購置/租賃/品項） | 0..1 | text | |
| otherReferralPlan | 其他轉介資源、服務（無論有無轉介皆須說明） | 0..* | text | |
| closeCaseNote | 複評後無失能欲結案，已提供相對應之資源訊息 | 0..1 | text | |
| serviceUsageTracking | 各項服務目標及整體計畫目標達成情形 | 0..1 | group | |
| homeServiceTarget | 長照服務使用情形追蹤 | 0..1 | group | |
 homeServiceStatus | 居家服務 | 0..1 | text | |
| professionalServiceStatus | 專業服務 | 0..1 | text | |
| transportationServiceStatus | 交通服務 | 0..1 | text | |
| respiteServiceStatus | 喘息服務 | 0..1 | text | |
| assistiveDevicesStatus | 輔具服務 | 0..1 | text | |
| referralProgress | 轉介家照服務資源 | 0..1 | text | |
| planSuitabilityChange | 整體計畫的適切性及需求異動 | 0..1 | text | |
| otherHandling | 其他處理事項（服務諮詢、申訴處理） | 0..1 | text | |
| Documentation for this format | ||||
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "questionnaire-aa02-example",
"meta": {
"profile": [
"http://ltc-ig.fhir.tw/StructureDefinition/LTCQuestionnaire"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"url": "http://ltc-ig.fhir.tw/Questionnaire/questionnaire-aa02-example",
"identifier": [
{
"system": "http://ltc-ig.fhir.tw/questionnaire-id",
"value": "AA02"
}
],
"version": "1.0.0",
"name": "AA02",
"title": "照顧管理問卷 (AA02)",
"status": "active",
"date": "2026-04-03T13:32:05+00:00",
"publisher": "經濟部產業發展署",
"contact": [
{
"name": "經濟部產業發展署",
"telecom": [
{
"system": "url",
"value": "https://www.ida.gov.tw/"
}
]
}
],
"description": "依 AA02 追蹤服務適應與介入、各項服務使用情形、計畫適切性與需求異動、其他處理事項之書寫範例而設計。",
"item": [
{
"linkId": "serviceAdaptation",
"text": "追蹤服務適應與介入情形",
"type": "group",
"required": true,
"item": [
{
"linkId": "contactTime",
"text": "聯繫時間",
"type": "dateTime",
"required": true
},
{
"linkId": "contactTarget",
"text": "電訪對象",
"type": "string",
"repeats": true
}
]
},
{
"linkId": "approvedServices",
"text": "核定服務類別及頻率（填入最新一筆計劃核定碼別及各碼別適應情形）",
"type": "group",
"item": [
{
"linkId": "homeServicePlan",
"text": "居家服務（應填寫碼別與服務單位）",
"type": "text",
"repeats": true
},
{
"linkId": "transportationPlan",
"text": "交通服務（金額/頻率/使用規劃）",
"type": "text"
},
{
"linkId": "professionalServicePlan",
"text": "專業服務（代碼/目標/對象/時間）",
"type": "text"
},
{
"linkId": "respitePlan",
"text": "喘息服務",
"type": "text"
},
{
"linkId": "assistiveDevicesPlan",
"text": "輔具服務（購置/租賃/品項）",
"type": "text"
},
{
"linkId": "otherReferralPlan",
"text": "其他轉介資源、服務（無論有無轉介皆須說明）",
"type": "text",
"repeats": true
},
{
"linkId": "closeCaseNote",
"text": "複評後無失能欲結案，已提供相對應之資源訊息",
"type": "text"
}
]
},
{
"linkId": "serviceUsageTracking",
"text": "各項服務目標及整體計畫目標達成情形",
"type": "group",
"item": [
{
"linkId": "homeServiceTarget",
"text": "長照服務使用情形追蹤",
"type": "group",
"item": [
{
"linkId": "homeServiceStatus",
"text": "居家服務",
"type": "text"
},
{
"linkId": "professionalServiceStatus",
"text": "專業服務",
"type": "text"
},
{
"linkId": "transportationServiceStatus",
"text": "交通服務",
"type": "text"
},
{
"linkId": "respiteServiceStatus",
"text": "喘息服務",
"type": "text"
},
{
"linkId": "assistiveDevicesStatus",
"text": "輔具服務",
"type": "text"
},
{
"linkId": "referralProgress",
"text": "轉介家照服務資源",
"type": "text"
}
]
}
]
},
{
"linkId": "planSuitabilityChange",
"text": "整體計畫的適切性及需求異動",
"type": "text"
},
{
"linkId": "otherHandling",
"text": "其他處理事項（服務諮詢、申訴處理）",
"type": "text"
}
]
}