Wed, Jul 04, 2018 - Page 4 News List

Centers to cut outpatient visits by 2%

REFERRALS:Hospitals and clinics have agreed to set up vertically integrated teams that would refer patients to appropriate providers to differentiate healthcare levels

By Lee I-chia  /  Staff reporter

The National Health Insurance Administration (NHIA) on Monday said that from this month, regional hospitals and medical centers would be required to reduce outpatient service visits by 2 percent each year.

As many people visit regional hospitals or medical centers for outpatient services and even minor illnesses, the agency last year began instituting policies to differentiate the levels of the healthcare system, with the goal of improving medical efficiency and increasing resource reserves at medical facilities for those with more serious conditions.

The policies included adjustments to the National Health Insurance program’s copayments for outpatient services and emergency room visits based on healthcare facility level and the launch of an online referral information exchange platform that gives patients booking an appointment higher priority with a referral.

Negotiations on the program’s medical expenditures have concluded, NHIA Deputy Director-General Tsai Shu-ling (蔡淑鈴) said, adding that regional hospitals and medical centers would be required to reduce outpatient visits — excluding severely ill patients and those referred from emergency rooms, other clinics or hospitals — by 2 percent each year.

Outpatient visits would be reduced by an estimated 800,000 in one year, Tsai said, adding that if a facility fails to meet the 2 percent goal, excess cases would not receive program payments.

“In the first half of this year, we also persuaded hospitals and clinics to establish vertically integrated medical teams, because only after doing so and referring patients in both directions can the differentiation of healthcare facility levels be realized,” Tsai said.

In the two-way patient referral system, patients with a chronic disease who are in a stable condition could be referred to clinics or local hospitals for checkups and to have their prescriptions refilled, while those with worsening conditions could be referred to larger hospitals, she said.

However, a key factor to the success of the referral system is good communication between doctors at different facilities to ensure patients feel safe when being treated by another physician, she added.

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