From hospital to home: National insights from Taiwan's hospital at home program

Taiwan's rapidly aging population has increased demand for acute care and heightened the risk of hospital-associated infections. This study evaluated the early nationwide implementation of the Hospital-at-Home (HAH) program launched by the National Health Insurance Administration to provide hospital-level acute care in patients' homes.

We conducted a descriptive analysis of 2160 HAH episodes discharged between July 2023 and March 2024 across 184 participating institutions. De-identified administrative data were summarized to describe patient demographics, primary diagnoses, care duration, clinical outcomes, service utilization, and safety indicators.

The mean patient age was 80 years, 53% were female, and 76% were dependent in daily activities. The leading diagnoses were urinary tract infection, pneumonia, and soft tissue infection. The mean HAH care duration was 6.7 days, compared with approximately 12 days for conventional hospitalization, and average expenditure was about half of inpatient cost. The treatment completion rate was 90%, with in-home mortality of 2% and 30-day mortality of 6%. Emergency visits and rehospitalizations within 14 days occurred in fewer than 5% of cases. Telemedicine, Internet of Things monitoring, and bedside diagnostics were widely integrated.

Nationwide HAH implementation in Taiwan demonstrated reduced hospital stay and cost while maintaining favorable safety and quality outcomes. The model provides a scalable, infection-conscious approach to strengthening acute care capacity in aging societies.