Taiwan's acute care at home program: Early national experience and evaluation using a logic model

Area of Science:

• Healthcare management
• Public health initiatives
• Home-based care models

Background:

• Taiwan's National Health Insurance Administration initiated the Acute Care at Home (ACAH) pilot program in July 2024.
• The program targets patients with pneumonia, urinary tract infection, or soft tissue infection, offering hospitalization care at home.
• This evaluation covers the initial nine months of the ACAH program's operation.

Purpose of the Study:

• To evaluate the performance of Taiwan's Acute Care at Home (ACAH) pilot program.
• To analyze the process and outcome components of the ACAH program during its first nine months.
• To assess key performance indicators and patient outcomes within the home-based hospitalization model.

Main Methods:

• A logic model was developed to establish the evaluation framework.
• Administrative data from the ACAH pilot program were analyzed.
• Process components (inputs, activities, outputs) and outcome components (short-term, intermediate) were described and stratified by admission model.

Main Results:

• The ACAH program served 2158 patients across three admission models between July 2024 and March 2025.
• Key utilization rates included 22.6% for remote monitoring, 17.8% for respiratory therapist consultation, and 12.2% for pharmacist consultation.
• Average hospitalization durations varied by condition (e.g., 7.92 days for pneumonia), with low 3-day (0.5%) and 14-day (2.9%) emergency department transfer rates and similar low readmission rates (0.6% and 3.7%).

Conclusions:

• The ACAH pilot program in Taiwan demonstrated encouraging performance in its initial nine months.
• The program shows potential for effective home-based hospitalization for specific infections.
• Further research should investigate long-term outcomes and the broader impacts of this home-based care model.