The National Health Insurance Administration (NHIA) yesterday announced a new policy that would increase the National Health Insurance (NHI) coverage for beds offered by metropolitan hospitals to patients transferred from the emergency units of academic medical centers, in its latest attempt to assuage the constant overcrowding at emergency rooms in large hospitals.
NHIA Director-General Huang San-kuei (黃三桂) announced the policy during a meeting of the legislature’s Social Welfare and Environmental Hygiene Committee yesterday morning, which was held to address the overcrowding situation.
“Starting next year, if a patient waiting in the emergency department of an academic medical center is transferred to a metropolitan hospital, the NHI coverage for the bed that the latter receives would increase from its usual amount of NT$1,046 (US$35) per day to what is normally allocated to the former, NT$1,180,” Huang said.
Based on the presumption that patients are admitted for an average of nine to 10 days, a transfer would mean that the NHIA pays up to NT$1,340 in additional coverage.
Huang said he expects the new policy to serve as incentive for metropolitan hospitals to help shoulder the overwhelming patient load at some of the most crowded emergency rooms in the nation.
Hospitals with overcrowded emergency departments include National Taiwan University Hospital (NTUH), Taichung Veterans General Hospital, Kaohsiung Chang Gung Memorial Hospital, Linkou Chang Gung Memorial Hospital, Buddhist Tzu Chi General Hospital, Far Eastern Memorial Hospital and Shin Kong Wu Ho-Su Memorial Hospital, Huang said.
In response to calls by legislators for improved transparency of medical institutions’ bed availability to allow relatively stable patients to be transferred to smaller hospitals, Huang said hospitals are obligated under the Medical Care Act (醫療法) to initiate the hospital-to-hospital transfer process when a patient has waited in the emergency department for more than 24 hours.
“The bigger problem is that some patients refuse to be transferred to another hospital, but a transfer program initiated by the NTUH last year might be the answer,” he added.
Under the NTUH’s program, Huang said patients that agree to be transferred are directly admitted into another medical institution rather than being kept waiting and their medical records are immediately forwarded.
“Patients unsatisfied with the second hospital’s service are granted priority to be transferred back to NTUH, but most do not transfer back,” Huang said.
A survey conducted by the Taiwan Health Reform Foundation in April showed that each year more than 3,700 people with first-degree injuries are admitted to emergency medical departments for two days before they are transferred to inpatient beds in hospitals.
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