ASTHO 2012: Integration of Public Health and Health Care in Taiwan Hospitals

Sep 13, 2012, 10:42 AM

Health promoting hospitals—it sounds like an obvious concept, but a reimbursement-driven focus on treatment rather than prevention actually makes this a somewhat novel idea. Now, the World Health Organization health promoting hospitals initiative incorporates health promotion concepts, values and standards into the organizational culture and daily routines of hospitals around the world. The concept also allows all hospital employees and their families, patients and their families, and community residents to participate in health promotion together.

Taiwan has the largest network of health promoting hospitals in the world, Shu-Ti Chiou, MD, director-general of Taiwan’s Bureau of Health, told state health officers attending the ASTHO meeting. In Taiwan, one-quarter of all hospitals have received status as a health promoting hospital and many more have signed on to cancer screening initiatives that give reminders to patients about certain cancer screenings no matter the primary reason for their hospital or clinic visit.

Examples in Taiwan include a tobacco awareness campaign by the Pingtung Christian Hospital for community residents. Participants who smoked were provided with referrals for counseling services, and the outpatient smoking reminder system kicked into gear every three months to create contact with the smoker and discuss their smoking status or quit plans.

At the Cardinal Tien Hospital in Yung Ho, through the health promoting program of hospital, the rate of women hospital employees aged 30 and above who have had a Pap smear has increased from 30 percent to 80 percent, while those aged 50 and above who received mammography screening has reached 82 percent, thanks to a reminder system in place at the hospital.

In an interview with NewPublicHealth, Dr. Chiou says she has seen individual examples of health promotion at a number of hospitals in the United States, and two health promoting hospital networks are now in place—with three hospitals each—in Connecticut and Pennsylvania, both at early stages of their work.

“No matter the reason for a hospital visit, health promotion is an opportunity during an outpatient or inpatient stay,” says Dr. Chiou.

While so far only 25 percent of beds are in health promoting hospitals in Taiwan, the national cancer screening initiative is in place in 232 hospitals that have installed automatic reminder systems for cancer screening in outpatient services. The hospitals provide screening reminders for four types of cancer: oral, cervical, breast and colorectal. When an oral cancer screening reminder is prompted, health professionals also ask about smoking status “and the next step is to invite smokers to join cessation services,” says Dr. Chiou.

“We have found that many hospitals see the concept as a win/win and are applying for [health promoting hospital] status, and we look forward to meeting more hospital leaders in the U.S. to share the concept,” says Dr. Chiou.

This commentary originally appeared on the RWJF New Public Health blog.