Research Article Health and Primary Care Health Prim Car, 2017 doi: 10.15761/HPC.1000118 Volume 1(3): 1-7 ISSN: 2515-107X A follow-up study observing health outcomes of the care recipients in the home and community-based service of the long-term care system of Taiwan Li-Fan Liu 1 *, Nai-Wen Guo 2 , Pei-Fang Su 3 and Jia-Jen Chen 4 1 Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan 2 Institute of Behavior Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan 3 Department of Statistics, National Cheng Kung University, Tainan, Taiwan 4 Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan Abstract Background: In planning for the country’s long-term care provision, the Taiwanese government launched the long-term care policy since 2007. Tere is a need to observe the follow-up health outcomes of care recipients and provide feedback to policy and practice. Purpose: Tis study explored the health outcomes of LTC recipients in the home and community-based service by following the changes in outcomes for two years, and examined the factors associated with. Methods: Te data came from the long-term care dataset (LTC-CM) of one southern city in Taiwan for people with LTC needs. In total, 1,338 care recipients who were reassessed by care managers from the baseline to two years (T0-T4) in the dataset were analyzed. Te descriptive and inferential analyses were conducted. Generalized Estimating Equations (GEE) were used to analyze four universal outcome measures, including the activities of daily living (ADLs), the instrumental activities of daily living (IADLs), the Short Portable Mental Status Questionnaire (SPMSQ), and the short version of the Centre for Epidemiologic Studies Depression Scale (CESD). Results: Diferent patterns were found with regard to the changes in outcomes of the care recipients and their characteristics that infuenced these changes. Te ADL scores increased from T1 to T3 (OR from T1-T3=1.27 to 1.21, p < 0.01) when compared with T0. Te IADL scores fell from T1 to T4 (OR from T1-T4=0.75 to 0.66, p < 0.001). Te average cognitive status decreased in T4 compared with T0 (OR = 0.85, p < 0.001). In contrast, the CESD outcomes increased (OR from T1-T4=0.73 to 0.55, p < 0.001). Age, gender, living status, educational level, social welfare status and the dependency level at baseline (T0) signifcantly infuenced the change of health outcomes. Conclusions/Implications for practice: Tis research found that the patterns of changes in outcomes moved in diferent directions. Te tendency of depression among care recipients had changed more positively. Exact monitoring and feedback of the health outcomes of care recipients are needed to efect improvements in policy and long-term care service practice. Correspondence to: Li-Fan Liu, Professor, Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Tel: +886-6- 2353535, Etn: 5730; Fax: +886-6-3028173; E-mail: lilian@mail.ncku.edu.tw Key words: health outcomes, home and community-based service, long-term care (LTC) Received: September 20, 2017; Accepted: October 09, 2017; Published: October 12, 2017 Introduction Te long-term care policies and service delivery With the trend of population aging, the long-term care need is increasing rapidly in Taiwan. In planning for the country’s LTC provision, the Taiwanese government launched the LTC 1.0 policy in 2007, aimed at helping frail elderly people with LTC needs, including the elderly aged 65 and over, people aged 50 and over with a disability certifcate, and aboriginals aged 55 and over [1]. To facilitate service delivery and reform the LTC policies, the government began transitioning to the development of a new LTC 2.0 policy as of 2016. Apart from institutional care, the LTC policy in Taiwan is aimed at developing home and community-based services (HCBS), such as home services, adult day care, home nursing care, home and community-based rehabilitation, home meal delivery, palliative care for caregivers and transportation services. Based on the household social welfare status, the LTC recipients need to co-pay 30%, 10%, and 0% of the LTC service charges for non-low, mid-low, and low- income households, respectively, and the fnancial subsidies are mainly provided by the central government. Te broad aim is to develop cost- efective and efcient ways of coordinating services in order to improve the quality of life [2]. Need assessments for receiving formal LTC services Multiple instruments from a national standardized questionnaire issued by the Ministry of Health and Welfare are used in need assessments, with a broad range of questions regarding physical health, mental health and functional ability. Based on this questionnaire, the