Page 118 - 2022 Taiwan Health and Welfare Report

By the end of 2021, the number of health facilities having contracts with NHI reached 29,802, of which 21,679 were contracted hospitals and clinics that accounted for 92.4% of the total medical institutions nationwide.
The tiered medical system has been reinforced since 2017, the NHIA has implemented six major strategies and related measures to encourage people to seek medical treatment in primary care facilities. If the physician deems it medically necessary for the patient to see a specialist, the patient will be referred accordingly for continuous and appropriate care. This allows medical centers and regional hospitals to focus on intensive care and medical research, and for primary clinics and district hospitals to serve as the gatekeepers for public's health. The proportion of outpatient showed a gradually rising trend for primary care facilities since 2017, and a slight decline for large medical institutions. (Figure 8-2)
Since 2020, the total number of medical visits decreased as a result of epidemic prevention
measures and reduction in medical visits by mild symptoms people, with the primary clinics seeing a significant reduction. As acute, severe, difficult to diagnose and rare disease patients went to large medical institutions routinely, the reduction in the proportion of primary clinic visits was larger than for medical centers or regional hospitals.
The vertical integration of the healthcare system is being actively promoted by NHIA by applying a patient-centric approach to the evaluation of people's care requirements so that they can be transferred to an appropriate department and hospital level for proper care or treatment. A total of 81 strategic alliances had been established by the end of 2021 involving 7,205 NHI contracted institutions.
To improve referral efficiency, an electronic referral platform that strengthened the referral process and two-way communications was introduced by the NHIA in 2017. The system was used by 11,267 institutions during the course of 2021 and approximately 1.40 million referrals were made.
20%
17%
14%
11%
8.0%
70%
60%
50%
40%
30%
20%
10%
Figure 8-2
Trends in Western Medicine Outpatient Visits at Each Level
Clinics
District Hospitals
Regional Hospitals
Medical Centers
68.0%
11.5% 11.3%
9.2%
64.7%
15.1%
14.8%
64.8% 63.1%
15.4% 14.9%
14.3%
12.1%
64.3%
61.3%
11.3% 10.7% 10.7%
9.9%
11.2% 10.1% 10.6%
10.6%
116
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Year
Source : National Health Insurance Administration, MOHW (NHIA)
Note : The dotted line section is the estimation using the compounded annual growth rate of cases over the last 10
years since 2018 prior to the implementation of tiered medical system.