Family physician system in Taiwan

Jan, Chyi-Feng; Hwang, Shinn‐Jang; Chang, Che-Jui; Huang, Cheng-Kuo; Yang, Ya‐Chen; Chiu, Tai-Yuan

doi:10.1097/jcma.0000000000000221

Cited by 11 publications

(16 citation statements)

References 6 publications

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“…Taiwan is a country with 23 million people, located at the eastern part of Asia. The Taiwan Medical Association was established in 1930, and there were over 49 thousand members in 2018, practicing in 22 medical specialties [ 14 ]. Family medicine, which topped the list of the specialties announced by the Ministry of Health and Welfare, was introduced to provide holistic care and to act as a gatekeeper of the health care system [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

To Work at Clinics or at Hospitals? Analysis of Family Physician Recruitment Advertising in Taiwan

Cheng

Tan

Hsu

et al. 2020

IJERPH

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Family physicians act as gatekeepers of the healthcare system and have an indispensable role in providing holistic care in the primary care system. While previous studies had focused on the geographic maldistribution of family physicians, the current study investigated the distribution of job opportunities for family physicians by analyzing recruitment advertisements posted in medical association journals, as an indirect way to observe the marketplace demand for physicians. We collected all the recruitment advertisements for family physicians in the twelve issues of the Taiwan Medical Journal, the official organ of the Taiwan Medical Association, in 2018. In contrast to 124 new trainees annually, 739 advertisements for family physicians were posted within the entire year. After eliminating repeated advertisements, there were 302 distinct advertisements, of which hospitals accounted for 18.9% (n = 57). The job opportunities at hospitals were offered mainly by regional hospitals (n = 26) and community hospitals (n = 29), but only two by medical centers. Family physicians in Taiwan were in great demand not only by primary care clinics but also by hospitals. The role of family physicians in hospitals is worth further study.

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Section: Methodsmentioning

confidence: 99%

To Work at Clinics or at Hospitals? Analysis of Family Physician Recruitment Advertising in Taiwan

Cheng

Tan

Hsu

et al. 2020

IJERPH

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“…The database of the FPICP, with the help of these extra datasets, enables research specific to the family physician system in Taiwan and was first used in a recent publication by the authors. 3…”

Section: Settingmentioning

confidence: 99%

“…One major intervention is the establishment of the Family Practice Integrated Care Project (FPICP). 3 In brief, the FPICP is a modified pay-forperformance (P4P) programme that affects…”

Section: Introductionmentioning

confidence: 99%

Impact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in Taiwan

Jan

Chang

Hwang³

et al. 2021

BMJ Open

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ObjectivesThe objective of this study was to explore the impact of Taiwan’s Family Practice Integrated Care Project (FPICP) on hospitalisation.DesignA population-based cohort study compared the hospitalisation rates for ambulatory care sensitive conditions (ACSCs) among FPICP participating and non-participating patients during 2011–2015.SettingThe study accessed the FPICP reimbursement database of Taiwan’s National Health Insurance (NHI) administration containing all NHI administration-selected patients for FPICP enrolment.ParticipantsThe NHI administration-selected candidates from 2011 to 2015 became FPICP participants if their primary care physicians joined the project, otherwise they became non-participants.InterventionsThe intervention of interest was enrolment in the FPICP or not. The follow-up time interval for calculating the rate of hospitalisation was the year in which the patient was selected for FPICP enrolment or not.Primary outcome measuresThe study’s primary outcome measures were hospitalisation rates for ACSC, including asthma/chronic obstructive pulmonary disease (COPD), diabetes or its complications and heart failure. Logistic regression was used to calculate the ORs concerning the influence of FPICP participation on the rate of hospitalisation for ACSC.ResultsThe enrolled population for data analysis was between 3.94 and 5.34 million from 2011 to 2015. Compared to non-participants, FPICP participants had lower hospitalisation for COPD/asthma (28.6‰–35.9‰ vs 37.9‰–42.3‰) and for diabetes or its complications (10.8‰–14.9‰ vs 12.7‰–18.1‰) but not for congestive heart failure. After adjusting for age, sex and level of comorbidities by logistic regression, participation in the FPICP was associated with lower hospitalisation for COPD/asthma (OR 0.91, 95% CI 0.87 to 0.94 in 2015) and for diabetes or its complications (OR 0.87, 95% CI 0.83 to 0.92 in 2015).ConclusionParticipation in the FPICP is an independent protective factor for preventable ACSC hospitalisation. Team-based community healthcare programs such as the FPICP can strengthen primary healthcare capacity.

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“…A brief explanation of propensity-score matching in this study is shown in Appendix 2. According to our previous study, FPICP patients had slightly lower prevalence of several chronic diseases, including diabetes, hyperlipidaemia, heart failure, hypertension, coronary artery disease, peripheral vascular disease, systemic embolism, cerebral vascular disease, and chronic kidney disease [3]. The presence of these chronic conditions are related to diabetes or its complications (macrovascular or microvascular) [7], and would influence the physicians' behavior of ordering related examinations.…”

Section: Target Populationmentioning

confidence: 99%

“…The SARS outbreak reflected the insufficiency of endemic disease preventive function in Taiwan's communities. FPICP was launched to empower primary care physicians by providing additional resources and facilitating vertical integration between primary care clinics and community hospitals to build up a primary community care network [3].…”

Section: Introductionmentioning

confidence: 99%

Team-based care improves quality of diabetes care -Family Practice Integrated Care Project in Taiwan

et al. 2020

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Background The Family Practice Integrated Care Project (FPICP) is a team-based program in Taiwan initiated in 2003. This study investigates the influence of FPICP on the quality of diabetes care. Methods This population-based cohort study used Taiwan’s National Health Insurance Administration data on FPICP (fiscal year 2015–2016, with follow-up duration of one year). Participants included diabetic patients aged ≥30 in primary care clinics. We used conditional logistic regression modeling of patient characteristics and annual diabetes examinations and compared FPICP participants with non-participating candidates. Main outcome measures included completion of annual diabetes examinations, including glycated hemoglobin (A1c), low-density lipoprotein (LDL), urine microalbumin (MAU), routine urinalysis (UR), and fundus examination (FE). Results The sample included 298,208 FPICP participants and 478,778 non-participating candidates. After 1:1 propensity score matching, the examination completion rates for FPICP participants and non-participants, respectively, were 94.4% versus 93.6% in A1c, 84.2% versus 83.8% in LDL, 61.9% versus 60.1% in MAU, 59.2% versus 58.0% in UR, and 30.1% versus 32.4% in FE. Conclusion Our findings indicate that a program like FPICP helps improve the quality of diabetes care through regular examinations of Alc, LDL, MAU, and UR.

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Family physician system in Taiwan

Cited by 11 publications

References 6 publications

To Work at Clinics or at Hospitals? Analysis of Family Physician Recruitment Advertising in Taiwan

To Work at Clinics or at Hospitals? Analysis of Family Physician Recruitment Advertising in Taiwan

Impact of team-based community healthcare on preventable hospitalisation: a population-based cohort study in Taiwan

Team-based care improves quality of diabetes care -Family Practice Integrated Care Project in Taiwan

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