Home-based advanced care is a solution to quality health care in rural Taiwan: Lessons learned during the COVID-19 pandemic

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-11-01 DOI:10.1016/j.jfma.2024.08.010

Sang-Ju Yu , Fei-Ching Yang , Ping-Jen Chen , Hui-Chia Chan , Jung-Yu Liao

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引用次数: 0

Abstract

Background/purpose

The integrated home-based medical care (iHBMC) program has been implemented by the Taiwanese government since 2016. The pandemic of coronavirus disease 2019 (COVID-19) accelerated the shift from hospital-based to community-based healthcare, with a special focus on advanced home care for frail older adults. This study focuses on home-based advanced care, such as hospital at home (HaH), aiming to explore the feasibility and resilience of HaH within a home-based medical care model in a rural community in Taiwan.

Methods

We conducted a retrospective review of medical records from February 2020 to August 2022. Two clinical professionals reviewed and abstracted data from the electronic medical records of 189 patients receiving home healthcare during the COVID-19 pandemic. The HaH event was calculated if patients had any acute infection and received treatment at home.

Results

A total of 62 HaH events occurred during 2020–2022 and the average HaH events per person was 1.4. In these events, the top reason for patients receiving HaH was pneumonia, followed by urinary tract infection, soft tissue infection, and sepsis. 77.4% of patients completed the HaH treatment and did not experience any recurrent acute infections in the 30-day follow-up.

Conclusion

Different forms of home healthcare enhance the resilience of medical care provision in rural areas. As Taiwan approaches a hyper-aged society by 2025, it is crucial that National Health Insurance policies support various home-based care models that address transportation issues and maintain high care standards in underserved rural areas.

查看原文本刊更多论文

家庭高级护理是台湾农村地区优质医疗保健的解决方案：COVID-19大流行期间的经验教训。

背景/目的：台湾政府自 2016 年开始实施综合居家医疗护理（iHBMC）计划。2019 年冠状病毒病（COVID-19）的大流行加速了医疗保健从以医院为基础向以社区为基础的转变，并特别关注体弱老年人的高级家庭护理。本研究聚焦于以家庭为基础的高级护理，如居家医院（HaH），旨在探索在台湾农村社区以家庭为基础的医疗护理模式中，居家医院的可行性和适应性：我们对 2020 年 2 月至 2022 年 8 月期间的医疗记录进行了回顾性审查。两名临床专业人员对 COVID-19 大流行期间接受居家医疗服务的 189 名患者的电子病历数据进行了审查和摘录。如果患者发生急性感染并在家中接受治疗，则计算HaH事件：结果：2020-2022 年期间共发生了 62 起 HaH 事件，平均每人发生 1.4 起 HaH 事件。在这些事件中，患者接受HaH治疗的首要原因是肺炎，其次是尿路感染、软组织感染和败血症。77.4%的患者完成了HaH治疗，并且在30天的随访中没有再发生急性感染：结论：不同形式的家庭医疗保健能增强农村地区医疗保健服务的适应力。到 2025 年，台湾将步入高龄化社会，因此国民健康保险政策必须支持各种居家医疗模式，以解决交通问题，并在医疗服务不足的农村地区保持较高的医疗标准。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464