Development of the Houston–Apollo model for older people living in remote areas in Taiwan

Abstract

Background: Senior healthcare is challenging in remote areas, especially in an economically disadvantaged population with a high portion of elderly constituents. Guided by Andersen's Behavior Model, this study examined whether a combined health care system (Houston-Apollo Model, HAM) will improve physical performance and foster medical care utilization of the local population. Methods: People aged ≥ 65 years who participated in congregate meal services (CMS) were recruited. Using concepts of telemedicine and community health records, participants received consultation from local clinics, which provided advices or arranged referral to National Taiwan University Hospital Yunlin Branch (NTUHYL). Physical parameters including blood pressure, body mass index, grip strength, walking speed, and ve-time sit and stand test (FTSST) were recorded and timely transferred to NTUHYL, which in turn result in individualization of intervention strategies. Changes in physical parameters and utilization of healthcare facilities were measured in the beginning of recruitment and one year later to evaluate the effectiveness of the plan. Results: 470 people were recruited. In 1-year follow-up, the mean systolic and diastolic blood pressure (mmHg) decreased from 137.4 to 133.3 (p = 0.019) and from 76.9 to 74.4 (p = 0.008), respectively. The mean time of FTSST (seconds) decreased from 11.3 to 10.4 (p = 0.011). The mean walking speed (m/s) increased from 0.71 to 0.74 (p = 0.039). The rate ratio (95%CI) of medical and dental outpatient clinic usage were 2 (1.1-3.64) and 1.14 (1.06-1.23), respectively. Conclusions: The HAM health care system could bene t the physical status of older adults, promote proactive and preventive health care utilization, and contribute to medical equality.

A proactive remote pharmaceutical care for rural elderly population: The Houston‐Apollo polypharmacy project

“…14 In November 2018, the National Taiwan University Hospital Yun-Lin branch (NTUHYL) launched the Houston-Apollo Model (HAM), a telemedicine healthcare integration system that was inspired by, and is named after, the Apollo Mission of the National Aeronautics and Space Administration (NASA), Houston, Texas, USA, to integrate the resources of the Yunlin government's CMS, local primary care clinic/physicians, and various professional healthcare teams of the National Taiwan University Hospital Yun-Lin branch (NTUHYL). 15 The HAM was set up with an aim to establish a proactive, preventive care system and finally improve the health outcomes of elderly individuals in remote, resourceconstrained areas. In the HAM, the National Taiwan University Hospital Yun-Lin branch (NTUHYL) functions as Houston's mission control centre to guide and support local primary care physicians via telemedicine.…”