Service Capacity and Access
From Ministry of Health and Welfare, ROC 2018-03-27
Basic hospital access and hospital bed density
According to MOHW statistics for 2017, Taiwan has 22,612 medical facilities comprising 483 hospitals and 22,129 clinics. The hospitals have 134,134 beds, equating to a bed density of 56.9 per 10,000 people.
Each year, around 65 percent to 75 percent of Taiwan graduates from nursing departments and schools become certified professionals. Of these, 90 percent go on to work in nursing related fields. In a given five-year period, an average of 10 percent of nurses aged 20-40 leave the profession. Only 60 percent of certified nurses currently work in the field. The government is pursuing reforms to encourage nurses to remain in the profession. Efforts implemented to date comprise: (1) inclusion of nurse-patient ratios in hospital evaluations since 2015; (2) an additional monthly bonus from the NHI to hospitals that achieve designated nurse-patient ratios; (3) publishing the nurse-patient ratios of all hospitals on a monthly basis since July 2016; (4) inclusion of nurse-patient ratio as part of establishment standards for hospitals in 2019; (5) raising the nurse density from 60.48 per 10,000 people in 2012 to 71.84 per 10,000 people by 2018; (7) establishing reporting system for workplace conflicts in health facilities in 2018.
In addition, Taiwan’s healthcare system is mainly formed by hospitals, and up to 80 percent of nursing personnel work in hospitals. Given the inadequate nursing workforce for community healthcare, the government launched an action plan in 2017 to increase the amount of facilities offering home care services around neighborhoods. By offering nursing professionals startup consulting services, evidence-based trainings and related technologies, they can have more opportunities to establish micro-enterprises that offer home care in communities. Such efforts can help facilitate a system that allows hospital nurses to apply their expertise to home care among communities.
Access to essential medicines
The NHI covers over 16,000 essential drugs and medications for rare diseases. As of January 2019, a total of 6,350 pharmacies nationwide were contracted under the system, and 24,825 drug licenses were issued. Taiwan Food and Drug Administration has also unveiled an essential medicine list, which comprises 294 items requiring pharmaceutical firms to report to the government if unable to continue supplying the listed medicines. An evaluation and reporting system for the shortage of listed essential medicines was also established to ensure public access to medications. Moreover, pharmacists in community pharmacy are also requested to provide patients education services to ensure safe medication use.
To ensure an equitable distribution of medical resources and further strengthen safety standards, the NHI Administration under the MOHW has enacted reforms in areas like monitoring and control of medication quality. Related measures include regular drug pricing investigations and the establishment of a cloud-based system enabling physicians to access patients’ medication records.