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Hospice wards are not available only in large hospitals or in cities.
In the national plan for health care network, there are 6 health care regions across Taiwan(Fig 4). About 1/3 of hospice wards and beds are in the Taipei Region, which includes 3 cities and one rural county. In other regions, the changes for increase are also observed.(Fig 5) With the ratio of hospice beds to cancer deaths, the comparison between regions is more practical. (Fig. 6)
While in the East region, the ratio seems to be the highest in most of the sampled years, challenges remain in providing service to the scattered homes in this vast area, including in the mountainous area.
On the other hand, the ratios in the North, the Central and the KPP regions were around half or even less than in the TPE region, although in recent years, narrowing in the gaps are observed.
Provide care beyond the hospice wards.
The National Health Insurance (NHI) subsidized hospice in-patient care since 2000, and Hospice home care
service since 1998. In addition, hospice combined care started as a trial program since 2004, supported by Bureau of Health Promotion, and then subsidized by the NHI since 2011. Thereafter, the list for institutes providing various care plan started to grow.(Fig. 4、 Table 2)
In 2004, 45 hospitals participated and provided 72 services, 29 in-patient wards and 43 home care services. In 2011, 88 hospitals participated, with 192 services. Among them, 7 hospitals provided only home care and 6 others only combined care. Today, as many as 170 hospitals and home care offices provide 341 different programs. Among them, 11 provide only home care and 43 only combined care. This means that most hospitals participating are able to provide 2 or more programs to meet the patients' needs.
In conclusion, the information of how hospice palliative care resources are allocated provide solid basis for further service planning. Numbers of actual provision of palliative care serviced from the NHI database will be even more valuable in finding out where more resource is more needed. Development of a timely and comprehensive palliative care network is vital in our aging society.
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Chapter 3
成長主題