Journal of the Formosan Medical Association = Taiwan yi zhi · 2025
Utilization of home-based traditional Chinese medicine in a homebound population under the integrated home-based medical care program in Taiwan.
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Chang Wen-Chiung, Su Yi-Chang
Аннотация
BACKGROUND: Home-based traditional Chinese medicine (HBTCM) was incorporated into Taiwan's Integrated Home-Based Medical Care (iHBMC) program in 2019. This study aims to examine HBTCM utilization and its associated factors in a homebound middle-aged and older population.
METHODS: We analyzed claim data for iHBMC visits from 2019 to 2021 using the National Health Insurance Research Database. Our study participants were iHBMC users aged 50 or older. Multivariable logistic regression and zero-inflated negative binomial regression models were performed to identify factors associated with HBTCM use and its volume.
RESULTS: A total of 1,507,454 iHBMC visits by 117,378 homebound individuals aged 50+ were identified; only 0.83 % of visits, from 1.48 % of the individuals, involved HBTCM. Of the HBTCM visits, 33 % were for stroke care and 28.3 % for dementia or other nervous system diseases. Individuals living in low-development (OR = 0.69; 95 % CI: 0.57-0.84) or remote areas (OR = 0.68; 95 % CI: 0.50-0.93), of older age (ORs: 0.75 for 65-79 years, 0.57 for 80-84, and 0.44 for ≥85), and with disadvantaged economic status were less likely to receive HBTCM. Having dementia (exp(β) = 1.31; 95 % CI: 1.13-1.51), cerebrovascular diseases (exp(β) = 1.19; 95 % CI: 1.05-1.34), or Parkinson's disease (exp(β) = 1.25; 95 % CI: 1.06-1.48) were related to a higher number of HBTCM visits.
CONCLUSION: HBTCM is primarily used for cerebrovascular and neurodegenerative diseases. Utilization of HBTCM appears insufficient, with notable social disparities in age, economic status, and regional development. Addressing disparities and improving access to HBTCM is crucial for homebound older patients with multiple healthcare needs.
METHODS: We analyzed claim data for iHBMC visits from 2019 to 2021 using the National Health Insurance Research Database. Our study participants were iHBMC users aged 50 or older. Multivariable logistic regression and zero-inflated negative binomial regression models were performed to identify factors associated with HBTCM use and its volume.
RESULTS: A total of 1,507,454 iHBMC visits by 117,378 homebound individuals aged 50+ were identified; only 0.83 % of visits, from 1.48 % of the individuals, involved HBTCM. Of the HBTCM visits, 33 % were for stroke care and 28.3 % for dementia or other nervous system diseases. Individuals living in low-development (OR = 0.69; 95 % CI: 0.57-0.84) or remote areas (OR = 0.68; 95 % CI: 0.50-0.93), of older age (ORs: 0.75 for 65-79 years, 0.57 for 80-84, and 0.44 for ≥85), and with disadvantaged economic status were less likely to receive HBTCM. Having dementia (exp(β) = 1.31; 95 % CI: 1.13-1.51), cerebrovascular diseases (exp(β) = 1.19; 95 % CI: 1.05-1.34), or Parkinson's disease (exp(β) = 1.25; 95 % CI: 1.06-1.48) were related to a higher number of HBTCM visits.
CONCLUSION: HBTCM is primarily used for cerebrovascular and neurodegenerative diseases. Utilization of HBTCM appears insufficient, with notable social disparities in age, economic status, and regional development. Addressing disparities and improving access to HBTCM is crucial for homebound older patients with multiple healthcare needs.