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[商品主貨號] U102006906
[代售商品編號] 101008601499
[ISBN-13碼] 9783031051593
[ISBN] 3031051599
[作者] Lee, Po-Chang,Wang, Joyce Tsung-Hsi,Chen, Tzu-Yu
[出版社] Springer
[出版日期] 2022/08/14
[內容簡介] (出版商制式文字, 不論標題或內容簡介是否有標示, 請都以『沒有附件、沒有贈品』為參考。)
Front Matter
Title Page
Foreword
Preface
Acknowledgments
About the book
Table of Contents
List of Contributors
List of Figures and Tables
Chapter 1: Introduction of Taiwan’s National Health Insurance
This chapter provides the overview of Taiwan’s National Health Insurance (NHI) System. In 1995, major social insurance programs, such as Labor Insurance, Government Employee Health Insurance and Farmers’ Insurance were merged and enlarged as the NHI to deliver universal health coverage. The payment system of the NHI is based on fee-for-service method since its inception. Besides, most of the health care is provided by private sectors, and there are no restrictions on patients seeking medical care. Though premium rate adjustment is stipulated in the National Health Insurance Act, it is not carried out as suggested because of political concern. As a consequence of the high medical accessibility, the volume of outpatient services is high and the NHIA has to develop various measures to maintain its financial balance. Assorted strategies were implemented by the NHIA for health equity, and the National Health Insurance MediCloud System, the NHI card, and My Health Bank were provided in order to ensure patient safety and enhance healthcare quality.
Chapter 2: Income of the National Health Insurance
The NHI is a compulsory national health insurance that provides universal coverage to all citizens of Taiwan and those who have had a registered domicile in the Taiwan area for six months. The insured’s right to access medical care is protected whether they suffer from illness, injury or require reproductive care. The first chapter introduces the financial structure of National Health Insurance, enrollment eligibility and how the premium and premium rate was calculated for different insured groups and their insured units. The collection of supplementary premiums, which correlate additional premium contribution to non-salary-based income, is explained as well. In order to maintain the financial independence and the liability system of the NHI, the premium rate, by law, is reviewed actuarially annually.
Chapter 3: Payment System of the NHI
The payment system has a great impact on the overall growth of medical expenses, the distribution of medical resources, and medical efficiency and quality. For quickly integrating the existing civil service, labor, and farmers’ insurance system, the fee-for-service approach was adopted as the primary NHI payment system at the beginning of the establishment. The second section elaborates the concept and operation mechanism of Global budget payment system and various supplemental payment methods in the NHI, such as case payment, per diem payment, pay-for-performance, Taiwan Diagnosis Related Groups (Tw-DRGs). The dilemma of securing RVUs or RVU Value to foster specific health care services was discussed in this chapter. The NHIA continues to revise the Fee Schedule to reflect technological progress, real clinical needs and reasonable rewards for health professionals. Here we introduce the Fee Schedule revision process and integration of HTA in the decision making. To close the inevitable budget gap, self-management of the global budget for each NHI district and payment department was designed to further contain medical costs.
Chapter 4: Comprehensive Policies on the National Health Insurance
With the sharply escalating medical expenses, The National Health Insurance Administration has implemented a number of programs to contain expenditure, deliver patient-centered health care, and meet the medical needs of the super-aged society that Taiwan will face in the future.
Taiwan followed the steps of many advanced countries to separate me
Po-Chang Lee, M.D., M.T.L. is the director general of the National Health Insurance Administration at the Ministry of Health and Welfare, Taiwan, in Taipei, Taiwan.
Joyce Tsung-Hsi Wang, M.D., M.P.H., Ph.D. is the director of the Planning Division, National Health Insurance Administration, at the Ministry of Health and Welfare, Taiwan, in Taipei, Taiwan.
Tzu-Yu Chen, M.S. is the associate researcher of the Information Management Division, National Health Insurance Administration, at the Ministry of Health and Welfare, Taiwan, in Taipei, Taiwan.
Chia-hui Peng, M.P.H. is the specialist of the Planning Division, National Health Insurance Administration, at the Ministry of Health and Welfare, Taiwan, in Taipei, Taiwan.
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