Objective: The problem of long-term healthcare for a disabled and aging population has gradually become a point of concern in many countries. Improvement of the quality of long-term healthcare is a topic that requires urgent focus. Thus, this study used the National Health Insurance (NHI) Claim Database to investigate differences in quality of care with regard to home care and nursing home services.
Methods: This study obtained data on 2006 inpatient and outpatient medical claims from the data of one million people in 2005 Health Insurance Database. A sample of 1,564 users of home care and nursing home services was taken. This study then investigated the difference in quality indicators of healthcare, drug use, and healthcare utilization among these users within a two-year period.
Results: Observation of users of home care services showed the following statistics: 4.5 % sought medical care due to depressive illnesses in the first year; 49.8 % sought medical care due to urinary tract infection (UTI) in the second year; 4.6 types of drugs were issued on average at each outpatient visit, and the average number of outpatient visits per year was 34.Observation of users of nursing home services showed the following statistics: 9.6 % sought medical care due to depressive illnesses in the first year; 62.1 % sought medical care due to urinary tract infection (UTI) in the second year; 4.2 types of drugs were issued on average at each outpatient visit, and the average number of outpatient visits per year was 49. The differences among users of home care services and users of nursing home services reached statistical significance. After other variables had been controlled, logistic regression analysis showed that the probability of depression (first year) and UTI (second year) among users of nursing home services was 2.62 and 1.54 times that of users of home care services, respectively.
Conclusion: Although NHI in Taiwan affords a similar degree of disability benefits to users of home care services and nursing home services, the quality of the two service models differs. Related medical referral units and service providers should plan health education and guidance, and improve index management and care processes as soon as possible, to enhance the quality of healthcare services.
