The Impact of Integrated Home-Based Primary Care on Continuity and Outcomes of Care Among the Community Homebound Older Adults in Taiwan
Meng-Tse Li, Yu-Chi Tung, Kuan-Liang KuoObjectives:
The homebound older adults are often at risk of poor care outcomes due to disability and limited access to health care. Home health care services have been developed to improve various outcomes of care. Since the initiation of the integrated home-based primary care (iHBPC) program in Taiwan, this study aimed to evaluate the effect of the iHBPC program on continuity and outcomes of care among the homebound older adults.
Methods:
Electronic medical records of all homebound older adults receiving home health care services from March 1, 2016 to April 30, 2022, in a hospital system in Taiwan were analyzed. Continuity and outcomes of care 12 months before and after participation in the iHBPC program were observed and compared with the control group by the propensity score matching method. Multivariate generalized estimating equation regression with the difference-in-difference method was performed after adjustment for patient characteristics to evaluate the impact of the iHBPC program on the number of physicians seen, emergency department visits, hospitalizations, and inpatient days.
Results:
A total of 912 patients were included. After propensity score matching, the intervention group participating in the iHBPC program for 12 months decreased the number of physicians seen, emergency department visits, hospitalizations, and inpatient days compared with the control group.
Conclusions:
The iHBPC program under Taiwan’s universal health care system improved continuity and outcomes of care for the homebound older adults by enhancing the accessibility, comprehensiveness, and coordination of health care. The promotion of this feasible and effective policy is anticipated to create additional benefits in the future.