Healthcare Reform in Taiwan Introduction to Taiwan Healthcare Reform Foundation (THRF)
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1 Healthcare Reform in Taiwan Introduction to Taiwan Healthcare Reform Foundation (THRF) July, 2013
2 Outline! Background! Mission and Vision! Guiding Principles! Organizational Structure! Key Activities! Future Directions
3 About THRF s n Established in:oct ( Taiwan n Location :Taipei (the capital of ( 205,000 ( NTD n Founding funds:10 million n Full-time staff:5 n Website:
4 Mission and Vision n Mission Promoting a healthcare environment that places quality and justice as its ultimate values. n Vision Advocating a patient-centered approach to healthcare reform.
5 Guiding Principles n Improving healthcare quality and patient s rights in Taiwan n Holding medical professionals and health care systems accountable n Raising healthcare issues in Taiwan through advocacies, public education, and publications
6 Organizational Structure Division of Administration Board of Directors Executive Committee Division of Public Relation Division of Research & Development
7 Executive Committee Ly-Yun Chang, Ph.D. Founging Chairman Professor and Research Fellow Institute of Sociology Academia Sinica Joanna S.C. Liu, Ph.D. Executive Director Associate Professor Department of Social Work National Taiwan University Mei-Chun Liu, Ph.D. Chairman Professor Institute for Labour Research National Chengchi University Phoebe Chen, Ph.D. Deputy Executive Director
8 Staff! Division of Research & Development Hsien-Kua Chu Chief Ya-Ting Chang Project Specialist Yun-Ting Lee Project Specialist Managing and organizing strategies of all events Labour regulation regime/ Patient safety/ Quality related issues Health care workforce/ Hospital accreditation/ Medical expense! Division of Public Relation Szu-Chia Chen Project Specialist, PR Public relation/marketing/fund-raising! Division of Administration Chao-Yen Chen Specialist Administration/Accounting /Human resource Other services provided by THRF: Medical disputes consulting service & Public education series
9 THRF S KEY ACTIVITES AND CURRENT PROJECTS
10 Introduction to Medical Disputes Consulting Service n Key issues 1. Patients and families have no idea what to do when confronting a medical dispute 2. Information asymmetry exits between patients and healthcare providers 3. Lack of accessible and reliable communication channels 4. Hospitals tend to hide mistakes from public disclosure Number of calls ( ): 4300 n Service Content 1. A consulting service line is running for medical disputes and other queries 2. An online grievance forum is launched 3. A brochure is published to provide information to patients who are dealing with medical disputes
11 Surgical Consent Form key improvement n Key issues 1. Surgery procedure 2. Benefits and risks 3. Alternative treatments 4. Recovery after surgery Old Version n Missing but important 1. Physician s statement 2. Extra copy to be retained by the patients Adopted by DOH in Aug. 2003
12 Press conference: Patients need a new version of surgical consent form with more information on it! UK Australia
13 Advocate Patients right to access their own medical records Key barriers n Make an appointment n Queue up again in the hospital n Have Doctor s permission TRUTH beyond barriers n Hospitals (or clinics) consider medical records as their properties and refuse to provide them to patients. DOH echoed and announced that medical institutions who refuse to provide necessary info to patients as required is against medical law
14 Medical receipt Reform Insufficient Details n Mixture of insurance /self payment n Treatments received and other medical service performed are not clearly listed? Patient s payable amount $572
15 New Version of receipt A lucky draw event DOH announced a new version of receipt
16 National Health Insurance (NHI) Reform Key Issues n Improve information transparency n Enhance citizen participation n Make changes to the payment system ( Pay for performance instead of Fee for service ) To amend current NHI Act, in August 2010, THRF urged legislators to pass secondgeneration health plan as soon as possible. n n Establish a more effective medical insurance fraud detection and prevention system Satisfy the health care needs of the poor people
17 Sweat-shop Hospital labor rights of physicians and Nurses n Key Issues 1. Medical manpower shortage 2. Hospital management overriding medical profession 3. Medical malpractice blaming individual physicians n Direction of Reform 1. "Hospital Accreditation standard" should be strengthened 2. Medical specialists be safeguarded by Labor Standards Act
18 2012- Medical Disputes Act n Key Issues 1. It s hard to apply for medical records 2. There is no channel for the medical grievances 3. No medical consultation offered and no one can help with the examination of medical records
19 Other Related Activities
20 A Journey of Thousand Miles Begins with One Single Step A philosophy of 5% achievement
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