Page 59 - TAIWAN TOBACCO CONTROL ANNUAL REPORT 2019

Comprehensive initiation of smoking cessation treatment In addition to outpatients, smoking cessation services now offered for inpatient and emergency care patients: Two treatment courses include 8 weeks / course, totally 16 visits and 16 weeks medication per year. Team-based smoking cessation education and mutual care network: In addition to medication, 16 smoking cessation instruction, care, and case management sessions were offered as well. Case management and tracking: Case management for 3-month of 6-month periods. Simultaneous focus on service quantity and quality: fee for service + pay for performance - Fee for service: Added "Quality Improvement Measures for Smoking Cessation Services" that could be applied for by all contracted medical institutions. Approved applications would waive the limit for the case number of smoking cessation services. - Pay for performance: Service performance would be assessed according several indicators that include number of cases serviced in the year, data collection rate for smoking cessation cases, success rates, and expenses incurred for smoking cessation success. Medical institutions with exemplary performance shall be commended. Since 2002, the number of cessation services provided has changed due to the implementation of new policies or subsidy adjustments. The revised provisions of the Tobacco Hazards Prevention Act were enacted on 11th January 2009, prohibiting smoking in indoor public areas as well as indoor working areas with more than three individuals. The number of clinical visits initially increased in the first 6 months but then started to decrease with every season from the second quarter of 2009 and stabilized by the second season of 2010. After initiating the Second Generation Cessation Services Payment Scheme on 1st March 2012, the number of clinical visits and patients using clinical visits rose also increased. By 2017, the total number of contracted medical institutions offering smoking cessation therapy was 4,200, distributed across 366 townships and cities (for a coverage rate of 99.4%, adding mobile health care will further increase coverage to 100%). Since the enactment of new Tobacco Hazards Prevention Act provisions in 2009 and increase in tobacco product surcharges, the total number of individual cases accepting smoking cessation therapy reached 1,061,945 (excluding returning cases) by November 2018 (Fig. 1-8). Fig. 1-8 800,000 700,000 600,000 500,000 400,000 300,000 200,000 100,000 0 Note: The number of people and samples does not equal the total as repetitions will be deducted. Trend of smoking cessation service volumn Number of people of outpatient clinics Number of outpatient clinics visits 733,113 705,953 565,534 491,127 27 313,748 379,335 9,4 3,7 71 62 12 3,3 60 9 239,951 4,2 84 156,830 186,692 140,720 128,421 169,930 64,592 70,432 53,721 48,765 64,959 9 28 6,9 6,3 09 41 12 5,5 20 15 3,1 48 15 4,8 44 192,082 191,5 14 45,277 5,81011,61121,866 22,180 44,580 10 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018Year 57 Reducing the Demand for Tobacco Volumn