Only 35% of Non-Cancer Patients Receive Hospice Care; Taiwan Promotes Home-Based End-of-Life Dignity with Incentives

Taiwan ranks first in Asia for the quality of death for terminally ill patients, yet statistics show that only 35% of non-cancer cases enter hospice care before death. The Ministry of Health and Welfare (MOHW) aims to improve the accessibility of dying at home with dignity through increased payments and rewards, with the first wave of incentives expected by the end of this year.

At a seminar on 'End-of-Life Medical Care and Ethics' today, Health Minister Shi Chong-liang noted that while Taiwan leads Asia, there is still room for improvement. Recent public debates on 'euthanasia' suggest that some feel the current system does not achieve the goal of a dignified death. Data reveals that about 60% of cancer patients receive hospice care in their final year, compared to only 35% for non-cancer patients.

Since 2024, the National Health Insurance (NHI) has included Advance Care Planning (ACP) coverage, expanding from inpatient to outpatient services for chronic disease patients. Shi emphasized that hospice quality is key; if quality is high, the demand for euthanasia decreases. Currently, 80% of hospice care is inpatient, while only 20% is home-based. To promote dying in place, the NHI is raising home visit fees and adopting value-based payments.

The NHI has launched the 'Quality Evaluation Bonus Incentive Scheme for Palliative Care.' Teams are graded as 'Good,' 'Excellent,' or 'Special Excellence,' receiving bonuses of 10%, 20%, or 30%, respectively. At least 60% of these rewards must be distributed to the staff. Over 100 institutions have applied, and evaluations will occur between mid-May and October, with results and payments finalized by year-end.