Page 108 - 2023 Taiwan Health and Welfare Report

08 2023 Taiwan Health and Welfare Report 08

Figure 8-2 Trends in Western Medicine Outpatient Visits at Each Level

Clinics Regional District Medical
Hospitals Hospitals Centers
23% 70%
68.0%
64.7% 64.8%
63.1% 65%
20% 62.0%

61.3% 60%
17%
55%

15.4% 15.3%
14% 14.8% 14.3% 14.9% 50%

12.1%
11.5% 11.3% 11.8% 45%
10.4% 10.7%
11%
11.3% 11.2%
10.6% 10.8%
10.1% 40%
10.1%
9.2%
8% 35%
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Year

Source: National Health Insurance Administration, MOHW (NHIA)
Note: The dotted line section is the estimation using the compounded annual growth rate of outpatients cases over the last 10 years since 2018
prior to the implementation of tiered medical system.

Due to COVID-19 pandemics since 2020, the overall Section 3 Improving Finances by
number of outpatient visits decreased (vs. the baseline Establishing a Linkage
number in 2017), where the level of primary clinic visits
Mechanism between Revenues
decreased significantly as less frequent visits from mild
and Expenditures
symptoms and intensified personal hygiene and prevention
For the sustainability of national health insurance, the
measures (significantly fewer medical visits for respiratory
Second-Generation NHI began to collect supplementary
symptoms, influenza and enterovirus). As acute, severe,
premium and increase government contributions to bring
difficult to diagnose and rare disease patients went to
premium collection in line with the ability to pay principle
large medical institutions routinely, the reduction in the
and improve the financial shortfall. As the end of 2022, the
proportion of primary clinic visits was larger than for
balance over the years was NTD 104.9 billion as shown in
medical centers or regional hospitals.
Figure 8-3.
The vertical integration of the healthcare system is
The Second-Generation NHI built up the financial
being actively promoted by NHIA by applying a patient-
revenue /expenditure linkage mechanism that routinely
centric approach to the evaluation of people's care
reviews premium rate annually. To consider the
requirements so that they can be transferred to an
affordability, medical environment and NHI finance, the
appropriate department and hospital level for proper
general premium rate starting from January 1, 2021, went
care or treatment. A total of 81 strategic alliances had
back to 5.17%, the rate before the Second-Generation
been established by the end of 2022 involving 7,152 NHI
NHI. The supplementary premium rate was linked to
contracted institutions.
adjust to 2.11%. The rate will be reviewed depending on
To improve referral efficiency, an electronic referral
economic recovery in the future.
platform that strengthened the referral process and
Section 4 Diverse Payment Methods and
two-way communications was introduced by the NHIA
in 2017. The system was used by 11,245 institutions Rational Management
during the course of 2022 and approximately 1.42 million The main payment method for NHI medical services
referrals were made. has been "Fee-for-Service (FFS)." To effectively control
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