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Aging May Cause Insufficiencies in The Five Major Medical Departments – The Ministry of Health and Welfare Employs Numerous Measures to Ensure Medical Security

  • Data Source:Ministry of Health and Welfare
  • Created:2014-12-20
  • Last Updated:2017-01-11

The media recently reported a research conducted by the National Health Research Institute concerning medical labor in hospitals in the future. The findings of this research suggested that aging has gradually become a serious issue in 5 major medical departments in the past decade, which may consequently create problems for people seeking medical advice. In response to future medical labor insufficiencies, the Ministry of Health and Welfare (MOHW) revealed its intention to increase the recruitment of undergraduate and graduate medical students in the attempt to increase the number of medical assistants (e.g., nurse practitioners and new clinical assistants) to assist in routine clinical care. In addition, the MOHW further aims to develop an integrated medical care model to reduce ineffective practice and utilize limited medical resources. 
In recent years, problems of medical labor insufficiencies in the internal medicine, surgery, obstetrics and gynecology, pediatrics, and emergency departments of hospitals in Taiwan have improved exponentially under the active promotion of numerous measures by the MOHW. This year (2014), the overall recruitment rate for medical staff in these five major departments has reached over 80%, with the pediatrics and emergency departments achieving over 90%. In addition, the second-year retention rate of resident doctors was close to 100%, confirming the efforts of resolving the labor insufficiencies in the five major medical departments. 
To resolve the labor insufficiency in the five major medical departments, the MOHW employed a multipronged approach to fully and continuously promote numerous measures to retain medical professionals in acute and critical care medicine. These measures are listed as follows: 

1. Increasing the NHI compensation structure for the five major medical departments: 
In 2013, a total of NT$ 5.055 billion of the Global Budget Scheme was budgeted to adjust the NHI compensation for department of acute and critical illnesses. In addition, a total of NT$ 22 million for western primary care was budgeted to adjust the NHI compensation for surgery and treatment items. 

2. Increasing resident doctor allowance of the five major medical departments: 
Allowance subsidization was introduced on September 1, 2013, where resident doctors of the five major medical departments could receive an allowance of NT$ 120,000 every year as an incentive for completing their professional training. At present, 3,073 resident doctors have received an accumulated allowance of NT $ 368.76 million. 

3. Appropriately adjusting the number of trainees for the five major medical departments: 
In 2014, the MOWH adjusted the number of trainees in specialized departments to 1,550 based on the number of graduates. In addition, the MOWH reviews and adjusts the number of trainees each year in the attempt to resolve labor insufficiencies in specialized departments that require 24h ER units and specialized departments in remote locations. 

4. Stipulating laws concerning the handling of medical disputes and piloting compensation mechanisms for birth-related incidents: 
Under the collective efforts of numerous hospitals, city and county mediation committees, and legal units, the number of medical disputes has drastically declined by 11%. In particular, gynecology-related disputes reduced by 77%. By reducing the pressure of medical disputes, resident doctors are more willing to enter the field of gynecology. This year (2014), the MOHW expanded its compensation pilot program for surgery- and anesthesia-related incidents in the attempt to improve present medical dispute conditions. 

5. Transferring relevant resources into remote areas: 
Regarding the “Critical Emergency Hospitals in Areas With Insufficient Emergency Medical Resources,” the MOHW increased the emergency examination budget by 30% to 50%, and awarded a point-value guarantee of 1 point per NT$ 1 for emergency cases. In addition, the MOHW appointed 19 medical centers to aid in emergency treatment as well as treatment of acute and critical illnesses in 17 remote hospitals that lack appropriate medical resources in 2013. Such an approach supplements for the medical labor insufficiencies of remote hospitals, exponentially increasing the medical labor and emergency response capacity in areas such as Kinmen, Penghu, and Lienchiang. Moreover, the MOHW anticipates expanding the number of hospitals and the scope of support provided by these hospitals in 2015, thereby ensuring the timely treatment of acute and critical illnesses. 

The MOHW asserted that in 2023, the medical labor insufficiency problem shall be most prominent in rural areas and in departments for acute and critical illnesses. The MOHW will collaborate with the Ministry of Education to increase the recruitment of medical students by re-introducing a publicly funded medical education system. However, in consideration of limited medical education resources, the MOHW plans to initially increase publicly funded medical students by 10%, narrowing these funds to departments that lack medical labor. Following the completion of their education and training, these students can then be appointed to serve in rural hospitals for a period of 4 to 6 years. 

Furthermore, in response to the lack of medical labor caused by the work specifications of resident doctors, the MOHW is currently in the process of deliberating a supportive measure to gradually increase the number of nurse practitioners on a yearly basis. Alternatively, the MOHW endeavors to establish a clinical assistance system to provide supervised support to attending and resident doctors in routine clinical care. In addition, the MOHW referenced the United States and developed an integrated medical care model, where dedicated beds are established in hospitals and attending doctors provide comprehensive care to inpatients, thereby encouraging the Hospitalist system. 

The MOHW continues to introduce various measures to resolve the medical labor insufficiency problem in the five major medical departments, creating incentive for doctors to enter the field of acute and critical illnesses, thereby satisfying the medical demands of the public. The MOHW hopes that its efforts can be recognized and supported by everyone.