Schedule change table of part of the burden of health insurance on the road

Need to re-announce and give the hospital a buffer period for modifying the system. The new system is scheduled to be implemented in July

[Reporter Lin Huiqin/Taipei Report] The first stage of the new system of outpatient medicine and emergency department burden was originally scheduled to start in April at the earliest, but Shi Chongliang, Director of Health Insurance of the Ministry of Health and Welfare, said yesterday that the adjustment of emergency department charges needs to be re-announced for 60 days, and the medical center The required system modification has a buffer period of at least one month, so it will be adjusted to July for implementation.

However, some hospitals believe that the replacement of the system does not need to be delayed until the second half of the year. If the medical community is ready, it should be on the road as soon as possible.

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It doesn't take that long to change the system

The medical profession urges to stop delaying and get on the road as soon as possible

Huang Zhaojie, the head of the medical management team of the National Health Insurance Department, added that before the new system of part of the burden was launched, groups such as the Emergency Medical Association reflected that the classification of triage is the basis for judging the order of treatment in emergency departments, and it does not necessarily represent the final severity of the disease. Classification of triage is used as a charging standard doubtful.

Xue Chengjun, secretary-general of the Taiwan Association of Emergency Medicine, explained that considering the fluctuation of the condition and the fact that urgency is not equal to the severity, two factors are considered. There may be doubts about using the initial triage classification as a part of the burden collection standard, so it is proposed to adjust the system.

The original plan of the National Health Insurance Administration’s new draft system for the burden of the emergency department maintains the charge of 150 yuan for grassroots institutions and regional hospitals, and reduces the fee for medical centers or regional hospitals to 450 yuan for more serious first and second-level triage. Three hundred yuan and two hundred yuan, and the lighter fourth and fifth grades will be raised from five hundred and fifty yuan to eight hundred yuan and six hundred yuan.

However, the latest version will adjust the charges according to the level of the hospital. District hospitals will maintain 150 yuan, regional hospitals will increase from the current 300 yuan to 400 yuan, and medical centers will change from the current 450 yuan or 550 yuan. Seven hundred and fifty yuan.

Huang Zhaojie explained that the relevant amount is mainly based on the collection regulations of the National Health Insurance Law, the analysis of the actual medical use of emergency departments in hospitals at all levels, and the principle that emergency departments cannot be cheaper than outpatient clinics. Advance notice.

Hong Ziren, chairman of the Taiwan Medical Management Association and vice president of Shin Kong Hospital, agreed with the adjustment. He pointed out that the original plan for emergency medical examinations in the medical center was changed to 300 yuan for the first and second levels, and 800 yuan for the fourth and fifth levels, a difference of 500 yuan. Yuan, in case the patient looks fine when he arrives at the emergency room, and then suddenly falls to the ground and needs first aid, but the initial triage assessment is considered less urgent and charges a higher part of the burden, which may increase the tension of doctors and patients in the emergency room and increase unnecessary troubles .

However, Hong Ziren also mentioned that the original implementation version last year was more complicated, and it took the hospital about two weeks to change the system. Now the content is becoming more and more simple, and the change time can be shortened. Maybe three days is enough, and there is absolutely no need to wait until the second half of the year. The new system of partial burden has been delayed for so long. If the medical profession is ready, it should start as soon as possible.

Due to the readjustment of the charging method for emergency medical services, the implementation of the new health insurance burden system will be postponed until July.

(file photo)