Case Study

The Taiwanese government has established an accreditation program for age-friendly healthcare institutions that helps promote effective care for older adults throughout the country.

Healthcare Access

The focus: Taiwan, as a rapidly aging society, wants its citizens to know where they can turn for high-quality care for the older population. Given the unique care needs of older adults and the discrimination that older adults can face, it is not always easy to know which institutions will serve older adults well; without incentives, institutions may fail to offer appropriate services to this population.

How it works: To improve older adults’ quality of care, the Health Promotion Administration (HPA) introduced an accreditation program in 2011 for age-friendly healthcare institutions, the first in the world initiated by a national government. Accreditation criteria cover four dimensions of healthcare: administration policy, communication and service, care procedures, and physical environment. The program began in hospitals and was expanded in 2012 to include public health centers, clinics and long-term care institutions, and now includes primary health centers. This national program awards special accreditation to hospitals and health institutions that, based on established criteria, provide high-quality care to older adults. The policy has specific health outcome targets, but it also takes aim at ageist practices by requiring health providers to focus on factors such as the intrinsic capacity of older adults and forming community partnerships to establish age-friendly cities. 

Enabling environment: The HPA was the catalyst for establishing the accreditation program at a national level and ensuring hospitals and health systems across the country were aware of the new policy. The HPA based its program on WHO’s "Health Promoting Hospitals and Health Services," which specifically focused on caring for vulnerable groups such as older individuals. In establishing the program, the HPA included representatives from healthcare institutions and academia for input on policy development. The Taiwanese government funded the program, and the HPA offered additional funding, including grants, to accredited hospitals for preventive services, which engaged key partners such as local public health departments and private providers. 

Impact: By the end of 2019, 652 institutions were certified, and 90% of surveyed older adults reported satisfaction with services provided at these institutions. This accreditation program aligns health system priorities with principles of equality, dignity and respect for older adults. Although the original criteria were developed primarily based on hospital practices, the government continues to optimize and adapt them to different types of institutions. The program has inspired similar efforts around the world in countries including South Korea, Austria and Greece.

Sources Include

Sources include:

Chiou S-T, Chen L-K. Towards age-friendly hospitals and health services. Archives of gerontology and geriatrics. 2009;49:S3-S6.

Huang N, Chien L-Y, Chiou S-T. Advances in health promotion in Asia-Pacific: promoting health through hospitals. Global health promotion. 2016;23(1_suppl):26-34.

Lin Y-Y, Huang C-S. Aging in Taiwan: building a society for active aging and aging in place. The Gerontologist. 2016;56(2):176-83.

Wu T-Y, Majeed A, Kuo KN. An overview of the healthcare system in Taiwan. London journal of primary care. 2010;3(2):115-9.