Home Healthcare Program Among Adults Aged 50 and Older: A RE-AIM Framework Evaluation Using 3-Year Real-World Data.

IF 1.6 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Evaluation & the Health Professions Pub Date : 2025-09-23 DOI:10.1177/01632787251380874

Zih-Syuan Yang, Huei-Ru Yang, Ping-Jen Chen, Fu-Wen Liang, Wei-Zhe Tseng, Sang-Ju Yu, Hung-Yi Chiou, Chao A Hsiung, Jung-Yu Liao

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Abstract

Home healthcare is a widely adopted health policy to address the needs of aging societies. This study examined Taiwan's home healthcare policy as a case example, assessing its implementation through the five dimensions of the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Taiwan's home healthcare policy, launched in 2016 as the "Integrated Home-Based Medical Care" (iHBMC) program, is reimbursed by the National Health Insurance. The study utilized data from the National Health Insurance Research Database and publicly available government sources. A total of 15,761 adults aged 50 years and above in the iHBMC program during its first year were identified, with 16% receiving home-based primary care (S1) and 84% receiving home-based advanced care (S2) (Reach). Prescriptions for chronic diseases and emergency department visits were significantly decreased among S1 and S2 patients after the iHBMC program (Effectiveness). Among all institutions delivering home healthcare, the majority were clinics (74%), followed by home nursing care agencies (18.3%) and hospitals (7.5%) (Adoption). Continuity of care was higher in S1 than in S2 (Implementation). More than 70% of participants engaged in the program for more than 6 months (Maintenance). These findings suggest the iHBMC program is feasible, improves healthcare utilization, and reduces hospital burden.

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50岁及以上成年人的家庭医疗保健计划：使用3年真实世界数据的RE-AIM框架评估。

家庭保健是一项广泛采用的保健政策，以解决老龄化社会的需要。本研究以台湾家庭医疗政策为个案，透过RE-AIM框架的五个维度（Reach、Effectiveness、Adoption、implementation、Maintenance）来评估其执行情况。台湾的家庭医疗政策于2016年推出，名为“综合家庭医疗”（iHBMC）计划，由国民健康保险报销。这项研究利用了来自国家健康保险研究数据库和公开的政府资源的数据。在iHBMC项目的第一年，共有15761名50岁及以上的成年人被确定，其中16%接受家庭初级护理（S1）， 84%接受家庭高级护理（S2）（Reach）。在iHBMC项目后，S1和S2患者的慢性病处方和急诊科就诊次数显著减少（有效性）。在所有提供家庭保健的机构中，大多数是诊所（74%），其次是家庭护理机构（18.3%）和医院（7.5%）（收养）。S1组护理的连续性高于S2组（实施）。超过70%的参与者参与该项目6个月以上（维护）。这些发现表明，iHBMC计划是可行的，可以提高医疗保健利用率，减轻医院负担。

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

Evaluation & the Health Professions 医学-卫生保健

CiteScore

5.30

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Evaluation & the Health Professions is a peer-reviewed, quarterly journal that provides health-related professionals with state-of-the-art methodological, measurement, and statistical tools for conceptualizing the etiology of health promotion and problems, and developing, implementing, and evaluating health programs, teaching and training services, and products that pertain to a myriad of health dimensions. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 31 days