Page 89 - 2018-19全民健康保險年報

After many years of laying the groundwork, the NHI system has earned international acclaim through its many major accomplishments, and also serving as a model for other countries in the process of building or reforming their systems. Looking ahead to the future, changes in Taiwan’s overall environment and social structure, and growing constraints on medical resources, the NHI will continue to perform rolling reviews for improvements. The NHIA plans to implements reforms in the following areas as it maps out its blueprint for the future:
Making the Most of Resources and Strengthening Division of Labor in the Healthcare System
In order to gradually implement a tiered healthcare system with a soud division of labor, the NHIA has drafted six strategies of “enhancing the capacity of primary care,” “diverting the public to get used to the referral system and adjusting copayments,” “Increasing payments to hospital for cirtical care as an incentive to reduce their services for minor illnesses,” “strengthening cooperation between hospitals and clinics to ensure continuous care,” “promoting the public’s capacity for self- care,” and “bolster the management of medical foundations,” and 24 accompanying measures. In the short-term, the NHIA seeks to strengthen primary care capabilities, and develop effective cooperation mechanisms among primary care clinics and hospitals. By enhancing medical quality and capabilities, it is hoped that primary care providers can offer the public superior care services, so that large hospitals can reduce their burden and focus more on the provision of emergency and critical care.The “vertical integration strategic alliance” formed by medical institutions
照跨步精進 展望未來
Recent Progresses and Future Outlook
have implemented two-way referrals to provide patients with continuous and patient-centered medical care and enhancing care quality through a vertical integration of the alliance’s upstream and downstream, collaboration among hospitals and clinics, use of electronic referral platform, and uploading and sharing of medical information using cloud technologies.
Continuous and Holistic Care from the Community to Hospitals
Residential Integrated Care
The NHI began implementing seven types of residential care, including basic home care for patients with impaired mobility, home care for patients with chronic mental illness, home care for ventilator-dependent patients, and hospice care since 1995. More than 100,000 people received home care medical services in 2015. It is well known that patients’ care needs can change during the home care process as their conditions shift. If a patient’s condition stabilizes, their treatment can be changed from general home care to home medical visits; if however their illnesses become terminal, their treatment can be changed from general home care to hospice care. As the type of treatment changes, patients may have to be transferred to institutions providing the necessary services.
In order to improve the fragmented service models of different types of home care, the NHIA integrated four types of service, including general home care, respiratory home care, and hospice care, as the “Integrated Home Health Care Program” in February 2016. In addition to strengthening case management mechanisms and promoting cooperative team care in the community, this program also calls for the horizontal integration
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