Page 110 - 2024 Taiwan Health and Welfare Report

2024 Taiwan Health and Welfare Report

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

Clinics Regional District Medical
Hospitals Hospitals Centers
23% 70%
70%
68.0%
64.7% 64.8%
65%
63.1% 64.0% 65%
20%
61.3% 61.5% 60%
60%
17%
55%
55%
15.4%
50%
14.8% 14.9% 15.2% 50%
14% 14.3% 14.5%
12.1%
45%
11.5% 11.7% 45%
10.4% 11.3%
11% 10.7% 11.5% 10.7%
11.3% 11.2%
40%
10.1% 10.6% 10.7% 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 To improve referral efficiency, an electronic referral
number of outpatient visits decreased (vs. the baseline platform that strengthened the referral process and two-
number in 2017), where the level of primary clinic visits way communications was introduced by the NHIA in
decreased significantly as less frequent visits from mild 2017. The system was used by 11,465 institutions during
symptoms and intensified personal hygiene and prevention the course of January through December of 2023 and
measures (significantly fewer medical visits for respiratory approximately 1.50 million referrals were made.
symptoms, influenza and enterovirus). As acute, severe,
difficult to diagnose and rare disease patients went to large Section 3 Improving Finances by
medical institutions routinely, the reduction in the proportion Establishing a Linkage
of primary clinic visits was larger than for medical centers Mechanism between Revenues
or regional hospitals. In 2023, the impact of the pandemic and Expenditures
on healthcare utilization stabilized. Overall, the number of For the sustainability of national health insurance, the
medical visits increased compared to the base period (2017). Second-Generation NHI began to collect supplementary
The number of visits to regional hospitals decreased, while premium and increase government contributions to bring
the numbers increased for medical centers, district hospitals, premium collection in line with the ability to pay principle
and primary care clinics. The proportion of visits to primary and improve the financial shortfall. As the end of 2023, the
care institutions (district hospitals and clinics) increased. balance over the years was NTD 138.8 billion as shown in
The vertical integration of the healthcare system is being Figure 8-3.
actively promoted by NHIA by applying a patient-centric The second-generation NHI program established
approach to the evaluation of people's care requirements so a financial revenue-expenditure linkage mechanism. The
that they can be transferred to an appropriate department National Health Insurance Committee annually determines
and hospital level for proper care or treatment. A total of 81 the total medical expenditure amount based on the
strategic alliances had been established by the December agreed-upon procedures and completes the review of
2023 involving 6,974 NHI contracted institutions. insurance premium rates, which is then submitted to the

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