Abstract
Senior healthcare is challenging in remote areas, particularly in an economically disadvantaged population. This study examined the benefits of a combined healthcare system (Houston-Apollo model) in improvements of physical performance and medical care utilization of local older people. People aged ≥65 years who participated in congregate meal services were recruited. Using concepts of telemedicine and community health records, participants received consultation from local general physicians, who provided advice or arranged referrals to the National Taiwan University Hospital Yunlin Branch. Physical parameters including blood pressure, body mass index, grip strength, walking speed, and five times sit-to-stand test (FTSST) were transferred to the National Taiwan University Hospital Yunlin Branch and local doctors in a timely manner. Changes in physical parameters and utilization of healthcare facilities were measured at the beginning of recruitment and 1 year later. In the 470 registered participants, 66% had hypertension, 50% had weakness in grip strength, 58% were slow at FTSST and 78% had disability in 6-meter walking speed. In total, 97 participants were followed up at 1 year. The 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 time of FTSST (s) decreased from 11.3 to 10.4 (P = 0.011). The walking speed (m/s) increased from 0.71 to 0.74 (P = 0.039). Medical and dental outpatient usage increased by 2 and 1.14 times, respectively. The Houston-Apollo model could provide benefits for the physical status of older adults, promote proactive and preventive healthcare utilization, and contribute to medical equality. Geriatr Gerontol Int 2021; ••: ••-••.
Highlights
Senior healthcare is challenging in remote areas, especially in an economically disadvantaged population with a high portion of elderly constituents
We provided training courses about how to use telemedicine devices and Baby Machine to the long-term care staff members working at every congregate meal services (CMS)
There were 8 primary care doctors and 727 older people who had registered in the 12 CMS (Fig. 2). 244 people did not have lunch in the CMS and received home meal services due to ambulation disability or work. 470 of the rest 483 people agreed to join the project under inform consent
Summary
Senior healthcare is challenging in remote areas, especially in an economically disadvantaged population with a high portion of elderly constituents. Taiwan has officially become an aged society since 2018 as over 14 percent of its population is 65 years old or above. Despite having more aged people in this agricultural county, seeking health services is a daunting task for them. Insufficient health and transportation services in the rural and remote areas have created barriers for these old people to seek medical help [1,2,3]. To bring down the barriers, telemedicine could be an effective approach [4], given that the broadband access had reached 96.7% coverage in rural and remote areas of Taiwan by 2017 [5]. To initiate a program that can integrate telemedicine to overcome the barriers of limited access to medical resources is timely and necessary
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
