A nationwide plan for postacute care of stroke in Taiwan

Authors

  • Cheng-Yang Hsieh,

    Corresponding author
    1. Stroke Center and Department of Neurology, Tainan Sin Lau Hospital, Tainan, Taiwan
    • Correspondence: Cheng-Yang Hsieh*, Stroke Center and Department of Neurology, Tainan Sin Lau Hospital, 51, Section 1, Dong-Men Road, East District, Tainan 70142, Taiwan.

      E-mail: chengyanghsieh@gmail.com

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  • Tsong-Hai Lee,

    1. Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Kueishan, Taoyuan, Taiwan
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  • Ku-Chou Chang,

    1. Department of Neurology, Chang Gung Memorial Hospital at Kaohsiung and Chang Gung University, Kaohsiung, Taiwan
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  • and on behalf of the Taiwan Stroke Society (TSS)


To the editor,

Taiwan's government is proud of its universal-coverage National Health Insurance (NHI) program [1]. Stroke is among the top five critical illnesses covered by the NHI [2]. About 26 098 patients were hospitalized for acute stroke in 2011; 16·2% had prolonged hospital stay (PHS, >30 days), which cost 56·4% of the NHI reimbursement for inpatient stroke care. To reduce the financial burden of PHS, the NHI program initiated a nationwide postacute care (PAC) plan for stroke in 2013. Its major goal is to develop a seamless system transfers for stroke patients from acute-care units to subacute rehabilitation or long-term care facilities. The Taiwan Stroke Society (TSS), coordinating with allied disciplines, took responsibility for the PAC plan from the NHI Administration in March 2013. Through infrastructure reforms, the plan is anticipated to improve patient outcome and reduce costs.

During the TSS annual meeting this September, interest groups of stroke patients were invited to explain their unmet need for rehabilitation and other postacute care. Physical, occupational, and speech therapy associations were also invited to present their updated evidence-based guideline for stroke rehabilitation. For the first time, busy strokologists in Taiwan took a first step by shifting focus from acute care (e.g., thrombolytic therapy) to postacute care of stroke patients. Topics about stroke rehabilitation, social welfare, and the continuum of care have garnered more attention. We hope that we would not forget ‘the other 97%’ [3].