「在宅急症照護試辦計畫」銜接長照服務規劃

Transitioning From a Pilot Program of Home Care for Acute Symptoms to Long-Term Care Services Planning

本文介紹了衛生福利部於2024年推出的「全民健康保險在宅急症照護試辦計畫」及銜接長照服務之配套措施。試辦計畫係期待針對特定急症病人給予適當之居家醫療照護作為住院的替代服務、將住院急症照護延伸至居家或住宿型機構，並於急性照護期間或結束後銜接長照服務資源。考量前述試辦計畫收案對象多為行動不便或需長期照顧之個案，治療期間將增加照顧服務之需求及照顧難度，故衛生福利部特予放寬收案對象若符合「長期照顧服務申請及給付辦法」之長照給付對象條件，在宅治療照護期間之長照服務使用規範可在既定長照服務給付上限額度及部分負擔比例下，由照管中心照顧管理專員及社區整合型服務中心個管員，依收案對象需求，在在宅治療照護小組之照顧範疇內彈性使用照顧組合；針對機構住民則配合於「減少照護機構住民至醫療機構就醫方案」增訂照護機構配合推動試辦計畫之獎勵指標。總結來說，這些措施旨在提升在宅急症照護的效率與品質，同時優化長期照顧資源的使用，以應對超高齡社會來臨醫療和照顧的挑戰。

The Ministry of Health and Welfare’s“Pilot Program of Home Care for Acute Symptoms”, launched in 2024, and complementary measures for long-term care services are introduced in this article. The goal of the pilot program is to provide appropriate home medical care to specific emergency patients as an alternative to hospitalization, allowing the extension of emergency care from hospitals to home and residential institutions and connecting long-term care resources during and after acute care. Given that many of those targeted by the pilot program are individuals with mobility issues or who require long-term care, and thus subject to higher levels of treatment difficulty and care service demand, the Ministry has relaxed the rules initially set for this program. Now, cases that meet the conditions for long-term care benefits under the“Regulations on Application and Payment for Long- Term Care Services”are eligible to access long-term care services during the home care period within the scope of care provided by the home care team without adjusting payment limits or co-payment terms. For institutional residents, additional incentive indicators for the pilot program have been incorporated into the“Plan for Minimizing Outpatient Visits by Institutional Residents”. In summary, these measures are designed to improve the efficiency and quality of home care provided to address acute symptoms while optimizing the use of long-term care resources to address future medical and caregiving challenges in Taiwan’s future super-aged society.