Taiwan's acute care at home program: Early national experience and evaluation using a logic model

Background: Taiwan's National Health Insurance Administration launched the Acute Care at Home (ACAH) pilot program in July 2024 to provide home-based hospitalization care for patients with pneumonia, urinary tract infection, or soft tissue infection. This study evaluated the program's performance during its first nine months. Methods: We developed a logic model to serve as the evaluation framework. We analyzed administrative data sourced specifically from the ACAH pilot program. We described the model's process components (inputs, activities, and outputs) and outcome components (short-term and intermediate outcomes). All statistics are presented as overall totals stratified by the admission model used. Results: From July 2024 to March 2025, the ACAH program included 2158 patients across Model A-direct home admission (679), Model B- nursing home admission (652), and Model C- emergency department-passed admission (827). Key service utilization indicators exhibited a remote monitoring usage rate of 22.6%, with respiratory therapist and pharmacist consultation rates of 17.8% and 12.2%, respectively. The mean medical cost was 31,856 points. The average hospitalization durations were 7.92, 6.22, and 6.12 days for pneumonia, urinary tract infection, and soft tissue infection, respectively. Within 3 and 14 days after program completion, 0.5% and 2.9% of all patients, respectively, were transferred to emergency departments. Readmission rates during these periods were 0.6% and 3.7%, respectively. Furthermore, the 14- and 30-day mortality rates were 4% and 7%, respectively. Conclusion: Taiwan's ACAH program demonstrated encouraging performance during its first nine months. Future evaluation should focus on long-term outcomes and impacts associated with the program implementation.