A longitudinal study of ventilator-dependent patients in Taiwan

In Taiwan, prolonged mechanical ventilation (PMV) has long imposed a substantial burden on healthcare systems, characterized by high ICU occupancy and escalating costs. To address these challenges, an Integrated Delivery System for PMV patients (PMV-IDS) was implemented in 2000, featuring stepwise care and payment reform. This study aimed to examine longitudinal trends in clinical outcomes and national health indicators associated with the PMV-IDS program.

In this retrospective, longitudinal, population-based study, we analyzed aggregate data from patients receiving mechanical ventilation between 2005 and 2023, sourced from the Ministry of Health and Welfare and the National Health Insurance Administration. Patients ventilated for ≥21 consecutive days were defined as PMV; those ventilated for >63 days were considered ventilator-dependent. Trends in weaning success, mortality, ICU resource utilization, and healthcare expenditures were assessed using descriptive statistics and linear regression.

From 2005 to 2022, newly ventilated patients increased by 15%. The proportion receiving prolonged ventilation (>63 days) decreased from 24% to 15%, and mortality declined from 25% to 18%. The weaning success rate within 21 ventilator days reached 70% in 2022. Mean ICU days decreased, and RCC occupancy stabilized after 2015. Home-based ventilator care increased from 3500 in 2013 to 4700 in 2023. Medical expenditures rose from 25.1 to 30.6 billion points.

This study describes epidemiological trends and associated healthcare utilization among patients receiving long-term mechanical ventilation under Taiwan's PMV-IDS framework. These findings provide a descriptive benchmark for this population. Given data limitations, future studies are warranted to refine these observations.