Mr. Wang, 78 years old, has many diseases, including meningioma, stroke, arrhythmia, and dementia. He once fell in the bathroom, resulting in a fracture in the left femoral neck. He went to Kaohsiung Medical University Chung-Ho Memorial Hospital (KMUH) for treatment and recovered well after surgery. He was evaluated by the medical team and determined to be qualified for the post-acute care program (PAC). Following discussion with his family, he was transferred to the PAC hospital near his house for subsequent care after discharge from the KMUH.
Dr. Sung-Yen Lin on the PAC team of KMUH from the Division of Orthopedics indicated that the family originally did not expect Mr. Wang to recover from the fracture and that they had prepared for the worst. Mr. Wang may have been bed-ridden for the long term, since he was admitted to hospitals frequently due to multiple disorders and repeated falls. He was later transferred to a PAC hospital. To give him more confidence in rehabilitative medicine, the KMUH team visited him regularly at the downstream hospitals twice to three times a week, and communicated face to face with the team at the PAC hospital on his condition: they observed wounds, removed sutures, evaluated muscle tone, and provided advice on physical therapy. Mr. Wang can now walk a short distance with a walker. Now, being bed-ridden is no longer the only option for the elderly following fractures. The family was happily surprised with the results.
The Kaoping (Kaohsiung and Pingtung) Division of the NHIA indicates that the PAC program, launched in 2014, is meant primarily to provide patients in the acute phase with continuous care after hospital discharge and up to recovery of physical performance. Currently, six types of disorders are payable, including: stroke, burns and scalds, traumatic nerve injury, fragile fracture, heart failure, weakness, and old age. The care service lasts 3 to 6 weeks. The PAC hospital provides highly intensive rehabilitation so that patients can recover as quickly as possible with the extent of their disability reduced, which will increase their ability to live independently. In Kaohsiung and Pingtung, there are in total eight PAC teams, consisting of 39 hospitals participating in the program. Enrollment has reached 1,435 people this year, and at present, approximately 10,000 people under the PAC program. In the aging society of Taiwan, many families cannot afford to take care of disabled elderly people. The implementation of PAC benefits more patients and also reinforces efficiency in the allocation of acute medical resources. It links with long-term care seamlessly, relieving the burden of care for the medical community, the society, and the family.
(For details on the post-acute care (PAC) program, you may contact: The Kaoping Division, National Health Insurance Administration, Ministry of Health and Welfare. Tel: 07-2315151)