A Real-World Evaluation of a Government-Led Incentive Program to Improve Infection Prevention and Control in Long-Term Care Facilities in Taiwan.

BACKGROUND:Long-term care facilities (LTCFs) are highly vulnerable to healthcare-associated infections, yet evidence evaluating policy-driven, incentive-based infection prevention and control (IPC) programs in these settings remains limited. METHODS:We conducted a retrospective policy evaluation using routinely collected on-site audit and administrative data from 59 LTCFs participating in the "2025 Taichung City On-site Inspection Program for Incentives to Strengthen Infection Control in Long-term Care Facilities". Facilities were assessed using standardized IPC indicators, including mandatory core indicators (Indicators 1-3) and voluntary incentive-based indicators (Indicators 4-6). Outcomes included indicator-level compliance, incentive qualification, reward distribution by facility type and bed-capacity category, and the results of post-audit appeals. RESULTS:Compliance with mandatory core IPC indicators was consistently high: all facilities met Indicator 1 (100%), and 58 facilities complied with Indicators 2 and 3 (both 98.3%). In contrast, non-compliance was more frequently observed among incentive-based indicators. Although 34 (57.6%) facilities applied for Indicator 4 and 48 (81.4%) for Indicator 5, non-compliance occurred in 8.8% and 4.2% of applicants, respectively. Indicator 6 demonstrated the greatest implementation gap, with 13 (76.5%) of 17 applicant facilities classified as non-compliant, primarily due to ineligibility of certified personnel. All nine appealed audit items were approved after review. Overall, 58 facilities (98.3%) qualified for incentive payments. CONCLUSIONS:A government-led, incentive-based IPC audit program was associated with near-universal compliance with core IPC standards in LTCFs. Linking structured audits, preparedness requirements, and financial incentives represents a feasible approach to strengthening IPC capacity in LTCFs.