Impact of integrated health care on elderly population: A systematic review of Taiwan's experience. (September 2022)

• Record Type: Journal Article
• Authors: Chen, Tai-Li; Feng, Yun-Hsuan; Kao, Sheng-Lun; Lu, Jing-Wun; Loh, Ching-Hui
• Is Part Of: Archives of gerontology and geriatrics. Volume 102(2022)
• Publication Date: 2022-09
• Subjects: Integrated health care system -- Taiwan -- Elderly -- Systematic review -- National health insurance program; Aging -- Periodicals; Geriatrics -- Periodicals; Gerontology -- Periodicals; Electronic journals; 305.26
• DOI: 10.1016/j.archger.2022.104746
• Languages: English
• ISSNs: 0167-4943

Abstract

Highlights: Taiwan comprises a fast-aging society and care fragmentation in health care services necessitates extensive integration to meet the growing demand of elderly population. This systematic review demonstrated that the integrated health care systems for multiple morbidities benefit the taiwanese geriatric population in physical and functional outcomes. Future well-designed studies are needed to provide evidence on integrated medicine during the COVID-19 pandemic. Abstract: Background: Care fragmentation in the elderly population prompted the need for integrated health care systems. However, evidence regarding the impact of the integrated care system in Taiwan is unclear. We aimed to conduct a systematic review to evaluate the impact of Taiwan's integrated health care programs on geriatric population. Methods: We searched bibliographic databases MEDLINE, Embase, Web of Science, and Airiti Library for relevant publications throughout May 2022. Studies investigating the effectiveness of Taiwan's integrated care programs were included. We used the critical appraisal skills programme (CASP) checklist, to assess the risk of bias of included studies. Results: Thirty-four studies, with a total of 838, 026 study subjects, were assessed. The systematic review on 11 subthemes (diabetes mellitus, chronic kidney disease, hepatitis C virus, fractures, cancer, dementia, atrial fibrillation, chronic obstructive pulmonary disease, mechanical ventilation, terminal illness, outpatients and community-dwelling patients), demonstrated that the implementation of integrated health care could not only provide benefits on survival, self-care ability, health quality, physical, and functional rehabilitation outcomes, but also significantly reduce medical utilization and expenditures. Conclusion: The integrated health care system for multiple morbidities benefits the Taiwanese geriatric population in physical and functional outcomes. The thematic synthesis provides references for future rigorous clinical trials.