ASSOCIATION BETWEEN TAIWAN ACUTE CARE AT HOME PILOT PROGRAM AND QUALITY OF EMERGENCY CARE...
Author(s)
YUANYUAN CHEN, PHD student1, Yu-Chi Tung, PHD2.
1Institute of Health Policy and Management, College of Public Health, National Taiwan University, TAIPEI, Taiwan, 2Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
1Institute of Health Policy and Management, College of Public Health, National Taiwan University, TAIPEI, Taiwan, 2Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
OBJECTIVES: Studies have indicated that Emergency department (ED) crowding compromises care quality and patient safety, partly due to delays in transferring admitted patients to inpatient wards. To reduce post ED admission pressure, Taiwan recently launched the Acute Care at Home (ACAH) Pilot Program,aiming to provide appropriate home based medical care for patients with acute conditions. This study examined whether participation in the ACAH was associated with improved efficiency in ED boarding and inpatient transfer.
METHODS: This cross-sectional study examined 190 Emergency Responsibility Hospitals under National Health Insurance (NHI) system. Using the emergency care quality information from the Health-care Quality Information Disclosure Network, we examined the associations between participation in the ACAH and the quality of emergency care (based on rates of transfer to an inpatient ward in less than eight hours among ED patients triaged as Levels 1, 2, and 3); this was achieved by performing multiple linear regressions controlled for health-care facility characteristics and regional characteristics.
RESULTS: A total of 149(78.42%) hospitals participated in the ACAH, while 41(21.58%) hospitals did not participate. Multivariable analysis showed that, compared with district hospitals, medical centers and regional hospitals had significantly lower rates of transfer to an inpatient ward in less than eight hours among ED patients triaged as Levels 1, 2, and 3. However, participation in the ACAH was not significantly associated with any of the three emergency care quality indicators.
CONCLUSIONS: The lack of observed improvement in ED boarding efficiency during the study period did not necessarily mean that the ACAH was ineffective. This might be related to the fact that the available data covered less than one year. Future studies should extend the observation period and incorporate additional indicators, such as ED hospitalization rates among patients with enrollment eligible conditions, to comprehensively evaluate the impact of ACAH on ED crowding and quality of care.
METHODS: This cross-sectional study examined 190 Emergency Responsibility Hospitals under National Health Insurance (NHI) system. Using the emergency care quality information from the Health-care Quality Information Disclosure Network, we examined the associations between participation in the ACAH and the quality of emergency care (based on rates of transfer to an inpatient ward in less than eight hours among ED patients triaged as Levels 1, 2, and 3); this was achieved by performing multiple linear regressions controlled for health-care facility characteristics and regional characteristics.
RESULTS: A total of 149(78.42%) hospitals participated in the ACAH, while 41(21.58%) hospitals did not participate. Multivariable analysis showed that, compared with district hospitals, medical centers and regional hospitals had significantly lower rates of transfer to an inpatient ward in less than eight hours among ED patients triaged as Levels 1, 2, and 3. However, participation in the ACAH was not significantly associated with any of the three emergency care quality indicators.
CONCLUSIONS: The lack of observed improvement in ED boarding efficiency during the study period did not necessarily mean that the ACAH was ineffective. This might be related to the fact that the available data covered less than one year. Future studies should extend the observation period and incorporate additional indicators, such as ED hospitalization rates among patients with enrollment eligible conditions, to comprehensively evaluate the impact of ACAH on ED crowding and quality of care.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
HSD6
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas