Objectives: Taiwan launched the integrated care demonstration program for ventilator dependent patients in 2000. The goal of the program is to shift these patients from ICUs to respiratory care centers, respiratory care wards or homes to ensure continuity of care with a reduced cost and resource. The present study evaluated the effectiveness of the integrated respiratory care program. Methods: A nationally representative health claim data from 1997 to 2011 was used. The patients with prolonged mechanical ventilation were defined as who used mechanical ventilator for 21 or more days consecutively. The study timeframe was divided into three periods according to the implementation of the program. Results:We identified a total of 14244 patients with prolonged mechanical ventilation. There are significant differences (p<0.001) in ventilator days between periods. The difference is mainly from the ICU. There are no significant differences in medical expenditure between the periods. However, using 2010 and 2011 data, we found the medical expenditure of patients who participate in the integrated care program was significantly less than those who did not (p<0.000). Conclusions:We recommend the demonstration program should be made it into a rule to get every prolonged mechanic ventilated patients involved in patient-centered integrated health care.
Date:
2013-12
Relation:
International Journal of Integrated Care. 2013 Dec;13(Suppl.):Article number 10-1-116005.
