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Building a Comprehensive Palliative Medical Care System and Promoting it to Hospitals and Communities

  • Data Source:Ministry of Health and Welfare
  • Created:2015-12-23
  • Last Updated:2017-01-10

To promote the development of local community palliative medical service, the Ministry of Health and Welfare has subsidized four hospitals in four regions this year (2015; Taipei City Hospital Zhongxiao Branch, Chi Mei Foundation Hospital, Ministry of Health and Welfare’s Hua-Lien Hospital and the Ditmanson Medical Foundation Chia-Yi Christian Hospital) to implement a trial project. The subsidized hospitals were used as core hospitals to provide a certain level of professional consultation and support for base-level clinics, health centers and community care facilities. These base-level medical clinics, health centers and home care organizations will provide residential palliative medical care service and establish a patient-based palliative medical care network. 

In a global ‘quality of death’ survey for terminally ill patients conducted by England’s Economist Intelligence Unit, Taiwan ranked 14 out of 40 countries surveyed (ranked number one in Asia) five years ago (2010). This year the number of countries surveyed increased to 80, but Taiwan’s ranking moved up to number six, which is a significant improvement of eight places (still maintaining its number one position in Asia). Taiwan was only behind England, Australia, New Zealand, Ireland and Belgium. This survey includes five major categories: end stage care environment, end stage care human resources, end stage care quality, end stage care burden and end stage care community participation. Singapore ranked 12th in this survey and was number two in Asia. Singapore’s Lien Foundation conducted an analysis of the reasons and found that Singapore was tied with Taiwan in the first four categories, but the difference in end stage care community participation was significant. In this category, Singapore ranked number 22 and Taiwan ranked number five. The reason was substantial government intervention. The Ministry of Health and Welfare has worked with civil groups since 2006 to promote voluntary Advance Hospice Palliative Care and Life-Sustaining Treatment Choices of Intent, and to make a note of this decision on the NHI IC card. This project has gradually shown results. As of the middle of December 2015, a total of 322,937 people have signed the Advance Hospice Palliative Care and Life-Sustaining Treatment Choices of Intent form, and this decision has been noted on their NHI IC card. An average of over 5,000 people per month signed this document in 2015. It is expected that the target of 400,000 advocates will be achieved in 2016. 

As part of organizations that promote the signing of the Advance Hospice Palliative Care and Life-Sustaining Treatment Choices of Intent (noted on the NHI IC card) from July 2014 to June 2015 with excellent performances, the Ministry of Health and Welfare gave awards to the following hospitals on December 23, 2015: Far Eastern Memorial Hospital, Taipei Veterans General Hospital, National Taiwan University Hospital, MacKay Memorial Hospital, Kaohsiung Medical University Chung-Ho Memorial Hospital, Linkou Chang Gung Memorial Hospital, National Cheng Kung University Hospital, Kaohsiung Chang Gung Memorial Hospital, Cathay General Hospital, Taipei Medical University Shuang Ho Hospital (built and managed by the Taipei Medical University), Kaohsiung Veterans General Hospital, Chia-Yi Christian Hospital, Taichung Tzu Chi Hospital, China Medical University Hospital, Changhua Christian Hospital, Chi Mei Hospital, Taipei Tzu Chi Hospital, Taichung Veterans General Hospital, Tri-Service General Hospital, Taipei Municipal Wanfang Hospital (Managed by Taipei Medical University), Taipei City Hospital Renai Branch, Shin Kong Wu Ho-Su Memorial Hospital, Cardinal Tien Hospital, National Taiwan University Hospital (Hsinchu branch), Liouying Chi Mei Hospital, Taipei Chang Gung Memorial Hospital, Cheng Hsin General Hospital, Kaohsiung Municipal Ta-Tung Hospital and Taipei Medical University Hospital, totaling 29 institutions. 

To increase the public’s awareness of palliative medical care, the Ministry of Health and Welfare has commissioned Taiwan Hospice Organization to establish a free palliative medical care consultation hotline (Tel: 0800-220-927; hospice for peace of mind). This hotline is dedicated to answering the public’s questions regarding palliative medical care. As a sign of respect toward life and dignity, patients are given the right to receive palliative care at the end of their life, and to have their wishes to die with respect and in peace respected. This includes hospice rooms in hospitals or choosing to accept hospice home palliative care in their own residence. This is to ensure the dignity of life and quality of death.