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Best Practice in Home-Based Medical Care for Neurodegenerative Diseases: the Taiwan Model
Enho Lin1, Chih-Ching Liu2, Chih-Yuan Lin3
1Shenzhen University School of Medicine, Shenzhen, Guangdong, China.
Objectives:
Neurodegenerative diseases pose increasing challenges to aging societies, requiring medical care models that extend beyond hospital-centered services. This article summarizes the development and implementation of Taiwan's home-based medical care (HBMC) model for people with neurodegenerative diseases.
Design:
Narrative policy review and descriptive synthesis.
Setting And Participants:
Taiwan's nationwide HBMC program is under the National Health Insurance system.
Methods:
This brief communication synthesizes Taiwan policy developments, programmatic structures, and implementation outcomes of HBMC, including its integration with advance care planning, acute care, home health care, post-acute care, and the hospital-at-home model.
Results:
Taiwan's HBMC has evolved through 3 stages, beginning with National Health Insurance-supported home health care in 1995, expanding into the integrated home-based medical care program in 2016, and advancing to the digitally enabled hospital-at-home model in 2024. The program demonstrates substantial structural capacity, effective care processes supported by telemedicine and point-of-care testing, and favorable outcomes, including reduced hospital utilization, lower healthcare expenditures, and effective targeting of functionally impaired older adults. Vertical integration across acute, post-acute, and long-term care services, together with horizontal collaboration among multidisciplinary teams, enables coordinated, continuous, and patient-centered care across the disease trajectory.
Conclusions And Implications:
Taiwan's experience highlights the feasibility and effectiveness of integrated home-centered care for neurodegenerative diseases and offers transferable insights for health care systems facing rapid population aging.
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