Purchasing health for the general public: Improving the quality of medical service

Promoting the Integrated Delivery System (IDS) plan for integrating the medical resources into mountainous regions and off-shore islands.

Mountainous regions and off-shore islands constitute about 45% of Taiwan’s land area. Due to the difference in development in urban and rural areas, medical resources in mountainous regions and off-shore islands are relatively insufficient. In order to solve the problem of insufficient accesses to the medical service for the general public in remote districts, the Kao-Ping Branch has introduced the current medical resources to the remote districts, and has promoted the IDS plan since 1998. Today, this plan has been fully implemented in twenty townships located in the mountainous regions and off-shore islands under the control of the Kao-Ping Branch. Dongsha and Nansha Islands, the furthest border regions of Taiwan, are also included.

The most distinguishing feature of the IDS plan is that the BNHI integrates the district hospitals, regional hospitals, medical center and local public health centers, and brings the medical and healthcare resources to remote mountainous regions and off-shore islands, and provides medical accessibility, or services such as specialty and mobile clinics. Ever since the launch of the IDS plan, resident doctors and regular specialist out-patient service have been available on holidays or at night in the mountainous regions and off-shore islands, where used to have no medical institutions or emergency service. The medical service is now offered twenty-four hours a day in those areas.

Set up a “Report on the quality of medical service information net”

Improving the medical service quality is the goal that the Kao-Ping Branch has unceasingly made efforts to achieve. Since 2000, the Kao-Ping Branch has cooperated with the industry, governmental organizations, and academic circle to conduct studies related to indexes of medical quality. The Kao-Ping Branch has also continually promoted the medical institution benchmarking, and the public trail project of report on the quality of medical service information net. All these have been awarded and recognized by the Executive Yuan and Department of Health.

In order to increase the general public’s right to know, and to make the medical information known to the public, the Kao-Ping Branch has actively cooperated with medical institutions, and integrated the platform of information flow for both medical institutions and patients. The Kao-Ping Branch also has investigated the medical information that the public is most eager to know, such as, how each medical institution uses antibiotics and injections, and set up an “ Report on the quality of medical service information net” on the web page of the Kao-Ping Branch for the general public.

Today, fourteen pieces of information has been posted on the “Information Net of Medical Service Quality,” in which 506 medical institutions are included. More than 130,000 people have logged in the website, with an 85 percent of public satisfaction rate.

Integrating social resources; assisting those economically disadvantaged people

Health is a guarantee of life quality, while maintaining the general public’s right of receiving medical treatment has been the responsibility of the BNHI. Since its launch in 1995, the NHI program has benefited numerous patients suffering from major illness and diseases, and their families over the past ten years. Due to the economic recession and increasing unemployment rate, however, some economically disadvantaged people have withdrawn from the program, failed to pay the premium for a long time due to financial difficulties, or never participated in the NHI program. Those people, as a result, are not able to enjoy the convenience and protection brought by the health insurance system.

Because of this, the Legislative Yuan passed the amendment in June, 2003, which aimed to offer assistance to those disadvantaged groups by having them be exempted from overdue premiums, postponing the payment, or providing necessary help to solve their problems. The special preferential measure lasted for only one year. Based on the statistics offered by the Kao-Ping Branch, more than 40,000 people in Kaohsiung City, Kaohsiung County, Pingtung County, and Penghu County are eligible for the special preferential measure. These people, however, might not be willing to apply for this special preferential measure, because they might not have enough information, or are afraid of having to pay the unpaid premiums. The Kao-Ping Branch, therefore, takes the initiatives to create the “Local Service Network for Health Insurance,” and actively cooperates with chiefs of villages, teachers, doctors, and civil representatives, who are familiar with local people and affairs, and act as go-betweens. They go deep into the community to find those economically disadvantaged people, and solve their problems of medical treatment, insurance enrollment, unpaid premiums, and IC Card at once.

The deadline for applying the special preferential measure was June, 2004. During this period of time, the Kao-Ping Branch held 285 workshops for publicizing the measure and localization service activities. More than 80,000 people were benefited, which fully displayed the efficiency of localized and timely service of the Kao-Ping Branch.