Utilization of Home Health Care under National Health Insurance Coverage in Taiwan

Background: Home health care services have grown rapidly in Taiwan since the launch of the National Health Insurance (NHI) in 1995. However, little is known about the home health care needs and utilization in Taiwan. Objective: The purposes of this study were to explore the needs and utilization of home health care under NHI coverage in Taiwan. Method: Data was extracted from 2002 “National Long-term Care Evaluation” Program, Executive Yuan. Proportional to Size sampling was used for adults were over 50 years old. A total of 13,979 adults who required assistance in at least one item of ADL or IADL were included in the study. The study also incorporated database from the 2002~2003 NHI claims for utilization of home health care. Results: Results showed that 14.7% of the 13,979 disabled adults required at least one item of skill nursing. The most needed services on skill nursing were self-care management (10.0%), insertion of nasogastric tube (5.9%), and urinal indwelling catheterlization (4.5%). A total of 835 (6%) disabled adults have used home health care within one year after survey. The average use of home health care were 7.8 times and 6.7 months. The expenditure of home health care averaged $14,155 NTD per user. Conclusions: Research showed that there was a gap between home health care need and utilization. Less use of home health care can be contributed to the limitations of NHI payment system. The study results may provide statistical data for utilization profile and determinants of home health care in Taiwan.