To ease growing public anger over instances of poor hospital conduct, the Bureau of National Health Insurance yesterday disqualified Taichung Veterans General Hospital from the bureau's Hospital Excellence Plan (
.
Since the plan was introduced in July, the bureau's Central Region Branch has received more than 200 complaint calls related to Taichung Veterans Hospital.
"They are turning patients away to save money," said Tsai Shu-ling (
The branch inspectors highlighted a case where the hospital's emergency room was overcrowded, yet 200 beds went unfilled for some time.
Tsai explained that the hospital did not refer patients with severe or acute illnesses to its own wards. Instead, the hospital opened temporary registration windows so patients could register to be admitted to other hospitals in the surrounding area.
The Taichung Veterans General Hospital enjoys a long-held reputation of being the leading medical center in central Taiwan. "With our cancer prevention center and 230 outstanding doctors, the hospital is standing on the front line to safeguard the health of Taichung residence," the hospital states on its Web site.
The disqualification from the Hospital Excellence Plan means that the hospital will not be eligible for bonus funding.
The Hospital Excellence Plan is a scheme used to determine how much extra funding a hospital should get each month. The plan provides incentives for hospitals who meet a host of standards, including balancing the ratio between outpatients and inpatients, and making the best use of hospital staff and other resources. The Bureau of National Health Insurance Bureau gives every aspect of a hospital such as treatment procedures, referrals, and prescriptions, a standardized value, and then converted the total of the values into to the budget delegated to a particular hospital's budget.
To separate those patients really in need from those with minor ailments, the plan is intended to pressure large hospitals into streamlining medical care and prioritize resources for the severely or chronically ill.
Twelve of the country's 17 large medical centers signed on the plan in July. In total, 229 hospitals -- 45 percent of the nation's hospitals -- have followed bureau's guidelines.
"We want large hospitals to play the role of caring for patients with serious or chronic diseases, rather than busy themselves prescribing cold medicine, painkillers, or otherwise acting as local clinic," said the Department of Health's Director-General Chen Chien-jen (
"With the bureau's objective of creating a sustainable medical system, we will keep pushing the Hospital Excellence Plan," Chen said.
The Taichung Veteran General Hospital receives a NT$400 million premium from the Bureau each month. For the past three months, however, the hospital has limited the number of outpatients per day and stopped giving medication to some patients with chronic diseases in order to save money.
The bureau's central branch visited the hospital four times last month and urged improvement, but with no obvious results, according to Tsai
"Nothing has been done to protect patients' right to medical care," Tsai said. "As a result, the hospital will not be eligible to enter into a contract with us until they redress their wrongs," she added.
According to Article 34 of the Insurance Special Contract Regulation (保險特殊管理辦法), the centerpiece of a contract between the bureau and a hospital involves patients rights, hospitals which violate patients' right to medical care will be expelled for up to three months.
Once disqualified, the hospital's level of funding will drop substantially from 0.8 for each budgeted dollar to 0.64, meaning the bureau will supply only 64 percent of the total expense the Taichung hospital monthly reported.
"[The hospital] suffers not only financial loss," said Huang San-kuei (黃三桂), the bureau's Vice President, "they have tarnished image."
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