Impact of the Home-Based Medical Integrated Program on Health Outcomes and Medical Resource Utilization in Home Healthcare Patients in Taiwan

• Published in: Clinical interventions in aging Vol. 19; pp. 1437 - 1444
• Main Authors: Ho, Yu-Chieh, Wang, Chia-Ti, Weng, Tzu-Chieh, Ho, Chung-Han, Tsai, Kang-Ting, Hsu, Chien-Chin, Lin, Hung-Jung, Chen, Hsiu-Chin, Huang, Chien-Cheng
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 31.08.2024; Dove; Dove Medical Press
• Subjects: Aged; Aged, 80 and over; Delivery of Health Care, Integrated; Emergency Service, Hospital - statistics & numerical data; Female; Health Care Costs; health outcomes; Home care; Home Care Services; home-based medical integrated plan; Hospitalization - statistics & numerical data; Humans; Male; Medical care; Medical research; medical resource utilization; Medicine, Experimental; Middle Aged; National health insurance; National Health Programs; Online databases; Original Research; Patient Acceptance of Health Care - statistics & numerical data; Patient outcomes; Quality management; Quality of Health Care; Retrospective Studies; Taiwan; Type 2 diabetes; Utilization; Taiwan; health outcomes; medical resource utilization; home-based medical integrated plan; Taiwan
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S457281

The home-based medical integrated program (HMIP) is a novel model for home healthcare (HHC) in Taiwan, initiated in 2016 to enhance care quality. However, the outcomes of this program on health outcomes and medical resource utilization in HHC patients remain unclear. Thus, we conducted this study to clarify it. The authors utilized the Taiwan National Health Insurance Research Database to identify HHC patients who received HMIP and those who did not between January 2015 and December 2017. A retrospective cohort study design was used. Convenience sampling was employed to select patients who met the inclusion criteria: being part of the HHC program and having complete data for analysis. A total of 4982 HHC patients in the HMIP group and 10,447 patients in the non-HMIP group were identified for this study. The mean age in the HMIP group and non-HMIP group was 77.6 years and 76.1 years, respectively. Compared with the non-HMIP group, the HMIP group had lower total medical costs for HHC, fewer outpatient department visits and lower medical costs, lower medical costs for emergency department visits, fewer hospitalizations, and a lower mortality rate (34.6% vs 41.2%, p<0.001). The HMIP is a promising model for improving care quality and reducing medical resource utilization in HHC patients. While this suggests that the non-HMIP model should be replaced, it's important to note that both non-HMIP and HMIP models currently coexist. The HMIP may serve as an important reference for other nations seeking to improve care quality and reduce medical resource utilization in their own HHC systems.