Yu Sang-Ju
MPH, MD, Chairman, Taiwan Society of Home Health Care, and Chief, Home Clinic, Dulan, Taiwan, ROC.
Hu Li Za Zhi. 2018 Feb;65(1):11-16. doi: 10.6224/JN.201802_65(1).03.
Taiwan's rapidly aging society is expected to make it a super-aged society in 2026. By 2060, people aged 65 or older will account for 40% of the population, a ratio that will approximate that in Japan. In Japan, the elderly population was 27.3% in 2016. By 2025, when the baby-boomers become 75 years old in Japan, issues of long-term care and end-of-life care will be more important and challenging. Since 1976, more Japanese have died in hospital settings than in home settings. Although the percentage of people dying at home increased slightly to 12.7% in 2016, after the recent introduction and promotion of home healthcare, Japan will face a significant challenge to deal with the healthcare 'tsunami' of high natural death rates, which is expected to impose a heavy death burdened on society by 2040, when the death rate is expected to reach 1,670,000/year. Therefore, the Japanese authorities have begun to promote the Community-based Integrated Care System, in which home healthcare and visiting nursing play crucial roles. This article summarizes the historical trend and current situation of visiting nursing in Japan. Japan uses a hybrid payment system for visiting nursing that is financially supported both through private medical insurance policies and Kaigo insurance (Japanese long-term care insurance). The total of 8613 visiting nursing stations that were active in community settings in 2016 cooperated with 14,000 support clinics for home healthcare and cared for 570,000 patients in home settings. We believe that visiting nursing will play an important role in home healthcare in Taiwan in the future.
台湾社会老龄化迅速,预计到2026年将成为超老龄化社会。到2060年,65岁及以上人口将占总人口的40%,这一比例将接近日本。2016年,日本老年人口比例为27.3%。到2025年,日本婴儿潮一代年满75岁时,长期护理和临终护理问题将变得更加重要且具有挑战性。自1976年以来,在医院去世的日本人比在家中去世的更多。尽管2016年在家中去世的人数比例略有上升,达到12.7%,但在最近引入并推广家庭医疗保健之后,日本将面临应对高自然死亡率带来的医疗保健“海啸”的重大挑战,预计到2040年,死亡率将达到每年167万,这将给社会带来沉重的死亡负担。因此,日本当局已开始推行以社区为基础的综合护理系统,其中家庭医疗保健和上门护理发挥着关键作用。本文总结了日本上门护理的历史趋势和现状。日本对上门护理采用混合支付系统,资金由私人医疗保险政策和介护保险(日本长期护理保险)共同支持。2016年,活跃在社区的8613个上门护理站与14000个家庭医疗保健支持诊所合作,为57万名居家患者提供护理。我们相信,上门护理未来将在台湾的家庭医疗保健中发挥重要作用。