Faced with potential personnel shortages and the need to free resources for critical care, the National Health Insurance Administration (NHIA) is hoping to significantly cut outpatient visits to bigger hospitals in the near future, NHIA Director-General Lee Po-chang (李伯璋) said yesterday.
The agency has set a goal of cutting outpatient visits to medical centers and regional hospitals by 10 percent over the next five years, Lee said.
Last year, there were 30.69 million outpatient visits to medical centers, up from 25.62 million in 2010, and 41.14 million outpatient visits to regional hospitals, up from 33.46 million in 2010.
If the goal is achieved, the rapid growth in outpatient visits to the two types of medical establishments seen over the past seven years could be reversed and would fall by a combined 7 million over the next five years, Lee said.
The nation has tried for more than a decade to institute a multi-tiered healthcare system designed to get the most out of its medical resources.
Under the system, the best-equipped medical facilities — medical centers and regional hospitals — are responsible for handling serious illnesses or critical cases while leaving less urgent or more routine cases to district hospitals and clinics.
The issue has taken on new urgency, because doctors will start to be covered by the Labor Standards Act (勞動基準法) in 2019, possibly cutting the amount of time they can work and creating a personnel shortage at major hospitals, Lee said.
With that in mind and to ensure that big hospitals have sufficient resources for critical and emergency care, the NHIA needs to channel outpatients to smaller healthcare facilities, Lee said.
The initiative would see doctors at medical centers and regional hospitals transfer patients diagnosed with minor ailments to district hospitals and clinics to avoid wasting medical resources, he said.
At the same time, patients with serious conditions who first visit district hospitals and clinics should be transferred to medical centers and regional hospitals, he said.
About 12 to 14 percent of outpatient cases at medical centers and 20 percent of those at regional hospitals involve basic medical care, such as respiratory infections, conjunctivitis, abrasions or fungal infections, Lee said.
In other words, about one in every five to eight outpatients may be using resources that would better serve people with more serious ailments, he said.
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