中醫居家醫療之現況與展望

Role of traditional Chinese medicine in home-based medical care in Taiwan: current status and prospects

本文藉由分析統整中醫居家醫療相關實證醫學及研究文獻，初探中醫於「居家醫療」的發展。近年來老年以及失能人口帶來醫療需求增加，政府整合並提升因失能或疾病特性外出就醫不便患者的醫療照護，自1995年陸續推動多項計畫，並於2016年正式實施「居家醫療整合照護計畫」，由整合性照護團隊提供「居家醫療」、「重度居家醫療」及「安寧療護」三階段的連續性照護。中醫雖為傳統醫學但有其獨特的醫療價值，以全人的觀點診治患者，也相當重視「預防醫學」，可應用在老年人口的預防失能、減緩失能加重程度、改善中重度失能個案健康問題上，也能協助提高整體照護品質。政府在2019年6月1日正式將中醫納入「居家醫療整合照護計畫」，有中醫照護需求之患者可申請中醫師至家中給予治療。本文以文獻回顧的方式，從中醫居家醫療及中醫治療老年與失能者常見疾病之實證經驗的角度出發，探討中醫在居家醫療團隊中的角色與貢獻，並回顧台灣健保居家醫療推動之歷史演進。（台灣衛誌 2022；41(1)： 16-35）

"Recently, the demand for home health care has increased in Taiwan, which has an aged society. The Taiwanese government has introduced several programs since 1995 to integrate and improve the medical care of patients who face difficulties visiting health-care facilities due to disability, illness or frailty. The Home-Based Integrated Care Program, which took effect in 2016, is a three-stage holistic program that incorporates home-based medical care, severe home-based medical care, and home-based palliative care. Traditional Chinese medicine (TCM) can be used for home-based medical care. In TCM, patients are treated with a special focus on preventive medicine; related treatments can be used to prevent disability, to slow the progression of disability, and to improve the health of older adults with moderate-to-severe disability. By improving individual health, TCM can also help improve the overall quality of health care. The Taiwanese government included TCM in the Home-based Integrated Care Program in June 2019. Patients who require TCM care can apply to receive such care at home. On the basis of our literature review, this paper examines the role and contribution of TCM in home health care with the support of empirical experience. The evolution of home health-care programs in Taiwan is also reviewed herein. (Taiwan J Public Health. 2022;41(1):16-35)"