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NHI to include neighborhood hospice care for terminally ill

TAIPEI, Taiwan -- The National Health Insurance Administration (NHIA) announced yesterday that neighborhood hospice care for terminally ill patients will be officially included in national health insurance plans from January.

According to the NHIA, 8,590 patients passed away while receiving hospice care in hospitals from January to October last year, and they typically spend 11 days on average in hospice care before passing away.

The NHIA said that 4,673 patients were under hospice care at home last year, mainly terminally ill patients suffering from cancer or motor neurone disease, the latter caused by damage to the nervous system.

However, the NHIA said that not every patient can receive hospice care because it is not universally available. Only 45 hospitals nationwide have hospice care wards, another 102 hospitals provide shared hospice care and 75 hospitals provide hospice care at patients' homes.

The NHIA said that it decided to adopt the New Taipei City's measure to allow doctors and nurses at local clinics to provide hospice care for terminally ill patients in their neighborhoods.

Lee Chun-fu (李純馥), an official with the NHIA, said that starting this January, terminally ill patients can choose between at-home hospice care or neighborhood care, which will allow them to receive medical care at home, and the only difference will be the training of medical personnel.

“Medical personnel for home hospice care require 80 hours of training and are mainly from hospitals that treat terminal diseases,” said Lee. “However, medical personnel for neighborhood hospice care only need 21 hours of training and are usually from local clinics that treat chronic diseases.”

Lee said that the NHIA will cover NT$725 for doctors who visit patients each time and NT$770 hourly for nursing care, which is about 25 percent of the cost of home hospice care.

“Patients who are in the final stage of cancer tend to be in a great amount of pain, so they might need pain killers that contain regulated ingredients like morphine,” said Lee. “However, doctors from clinics might not know how to control the dosage, so a year after launching this policy there will be a review on how to improve it.”

According to the NHIA, there will be around 500 patients using neighborhood hospice care in the first year after the new policy is included in the insurance plan.

The NHIA said that based on statistics collected in 2012, about 30,000 people have needed to receive hospice care and over 80 percent of them are patients who are in the final stage of cancer, while 95 percent of terminally ill patients pass away in hospitals.

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