{"title":"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。","authors":"Sang-Ju Yu , Fei-Ching Yang , Ping-Jen Chen , Hui-Chia Chan , Jung-Yu Liao","doi":"10.1016/j.jfma.2024.08.010","DOIUrl":null,"url":null,"abstract":"<div><h3>Background/purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Home-based advanced care is a solution to quality health care in rural Taiwan: Lessons learned during the COVID-19 pandemic\",\"authors\":\"Sang-Ju Yu , Fei-Ching Yang , Ping-Jen Chen , Hui-Chia Chan , Jung-Yu Liao\",\"doi\":\"10.1016/j.jfma.2024.08.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background/purpose</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>\",\"PeriodicalId\":2,\"journal\":{\"name\":\"ACS Applied Bio Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Bio Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0929664624003619\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MATERIALS SCIENCE, BIOMATERIALS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Bio Materials","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0929664624003619","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MATERIALS SCIENCE, BIOMATERIALS","Score":null,"Total":0}
Home-based advanced care is a solution to quality health care in rural Taiwan: Lessons learned during the COVID-19 pandemic
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.