Reported by Lo Chen, Wei Hsin-Hsin and Wang Min-Hsu
In response to the “emergency clinics” system proposed by some doctors, Shih Chung-Liang, Director of the Division of Medical Affairs of the MOHW, expressed that the MOHW welcomes this idea and may strategically support it in the future if the system proves effective. Dr Lee Po-Chang, Director-General of the NHIA, pointed out that it is one of the NHIA’s major tasks to promote the graded healthcare system. The NHIA plans to expand the cloud-based health record system so as to make it more convenient for patients to receive treatments in clinics.
However, some doctors in the primary care sector pointed out that the NHI currently neither reimburses clinics for emergency services, nor pays extra for out-of-hours services. Clinics will have to overcome many obstacles to get NHI reimbursement for emergency services. Also, as the NHI sets separate global budgets for hospital and primary care sectors, “emergency clinics” may further depreciate the point-value for primary care sector.
Shih Chung-Liang expressed that only about 20% of the patients visiting big hospitals for emergency services need in-hospital treatments. Most patients go home straightaway after receiving treatments. Hospitals in many countries, including the UK and the US, have implemented a system similar to “emergency clinics” in order to ease the congestion in the emergency wards and to provide out-of-hours services for patients.
Dr Lee Po-Chang pointed out that the NHIA has been promoting the cloud-based patient records system since last year so as to allow primary care doctors to access patients’ test and examine results. By doing so, the public may increase their confidence in the primary care clinics. Dr Lee hopes patients would firstly go to clinics for treatment. He conceded that the concept of “emergency clinics” is quite a challenge; however, the NHIA is open for discussion about the reimbursement issues.
Zhan Chien-Jun, Director of the General Practice Association, pointed out that patients using emergency services can basically be put into two categories: those who are suffering from life-threatening conditions and those who are not able to access GPs. The emergency clinics will certainly help the second category and hence ease the workload of emergency wards in big hospitals. The problem is that the NHI does not currently reimburse clinics for emergency services.
According to the Health Department of the New Taipei City, “emergency clinics” seems not compatible with the services provided by big hospitals’ emergency wards because the facility standards are too different. “Emergency clinics” is basically just a 24-hour clinic services. It should not be referred to as “emergency service”. The NHI reimbursement of such out-of-hours service should be at the MOHW’s discretion.
【2018-02-20/ United Daily】