Are hospital emergency rooms overcrowded, leaving patients waiting for hours or even half a day? On the 25th, the National Health Insurance Administration (NHIA) held a joint meeting, passing the "Home Emergency Care" initiative, scheduled for a trial launch in the second half of this year. This program aims to allow some emergency cases to receive care at home, reducing the burden on hospitals and addressing patients' caregiving needs. NHIA Director Chung-Liang Shih stated that telemedicine consultations and treatments will be implemented in July, with an estimated budget of around 300 million NT dollars over six months.
The target recipients are individuals with pneumonia, urinary tract infections, or soft tissue infections who require hospitalization but are suitable for home care. They must meet one of the following three criteria: Mode A, home cases originally designated for home care or palliative care; Mode B, residents of long-term care facilities; Mode C, emergency cases with disabilities (Barthel Index score below 60).
Director Shih explained that Mode A caregiving teams will serve existing "elderly and chronically ill patients." Mode B involves caregiving teams conducting visits to facilities, in line with the Ministry of Health and Welfare's plan to reduce residents' hospital visits. Mode C entails hospitals with congested emergency departments applying for the program, especially aiming to address bed shortages and long emergency wait times. This initiative aims to alleviate hospital burdens through home medical care services.
Furthermore, Director Shih pointed out that individuals with pneumonia, urinary tract infections, or soft tissue infections often require antibiotics. These patients face greater difficulties in daily living activities while hospitalized, beyond medical treatment. Caregivers cannot afford to provide both medical and daily care, and families struggle with the burden of commuting to hospitals. With home care, individuals can stay at home or in long-term care facilities without disrupting their daily routines. This not only optimizes resource utilization but also reduces the burden on families.
Director Shih emphasized that while the NHIA joint meeting has approved the initiative, a proposal-based trial approach will be adopted. Teams will be selected for trial implementation in all six medical regions after information sessions, with interested and qualified teams applying for approval. The initiative will be implemented on July 1 in conjunction with telemedicine consultations. The budget for the second half of the year is approximately 350 million NT dollars, including 150 million NT dollars for community hospitals and 200 million NT dollars for other teams.
Approximately 80,000 individuals qualify for Mode A, and about 120,000 for Mode B. Based on past experience, it is estimated that one-quarter to one-third of these individuals are hospitalized at least once a year due to the aforementioned infections, benefiting around 50,000 people annually. However, Director Shih stated that cooperation with trial teams is essential, so the conservative estimate for the first year is to benefit 10,000 people.
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