The National Health Insurance Administration (NHIA) yesterday said its annual expenditures more than doubled in the past two decades, with some patients misusing the system.
Annual expenditures increased from NT$252 billion (US$8.37 billion) in 1998 to about NT$593.3 last year, the agency said.
Some of the additional costs were incurred by an excessive use of resources by a small number of people, the agency said, adding that one patient last year requested 24 computerized tomography (CT) scans.
A total of NT$68.8 billion was spent on the 20 most expensive National Health Insurance (NHI)-covered examination procedures last year, including NT$9.2 billion on CT scans, NT$9.1 billion on ultrasound imaging, NT$5.9 billion on magnetic resonance imaging (MRI) scans and NT$5.5 billion on cardiac enzyme and lipid profile tests.
An analysis of the expenditure growth showed that annual spending on CT scans increased from NT$3.1 billion to NT$9.2 billion since 1998, while spending on MRI increased from NT$1.3 billion to NT$5.8 billion.
NHIA Director-General Lee Po-chang (李伯璋) said that while the agency respects the decisions of medical professionals, it questioned the need for repeated and redundant examinations, citing the case of a 36-year-old man in central Taiwan who received 24 CT scans at seven hospitals in one year for the same head injury and chest pains.
Other cases last year included a person who had 96 hematology tests, another who had 21 abdominal ultrasonographs and a third undergoing 10 MRIs, Lee said.
“Examinations such as ultrasounds and CT scans are non-invasive, so some patients might feel less stressed by the procedures, and considering their efficacy and convenience, they are indeed helpful in diagnosis,” Lee said.
However, repeated examinations within a short period of time is mostly redundant and becomes a burden in the NHI system, he added.
To achieve a more reasonable distribution of medical resources, the agency is pushing for a system that shares information about patients’ examinations across the NHI network so that healthcare professionals can see patient records for the previous six months.
NHIA official Tzeng Wen-fu (曾玟富) said patients who had CT scans and MRIs more than three times in 90 days, abdominal ultrasonographs more than twice or X-rays on the same body part more than 10 times in one month, would be listed as subjects for purposive review to understand how the person is using NHI resources.
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