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Taiwan’s NHI Program: An Economic Analysis of Physicians Working in a Community United Clinic
community-oriented primary care
sustainable health care
With the high coverage rate, the National Health Insurance (NHI) program in Taiwan has provided people more incentives for achieving improved health when choosing from available forms of medical care during their times of sickness. At the same time, however, associated costs and related expenses currently far exceed the income NHI is able to collect for its services. In urban areas people regularly seek medical care in larger medical care centers as opposed to smaller community clinics both for emergencies and for the routine checkup of chronic diseases such as hypertension and diabetes. Without any effectively managed mechanisms of separation between large medical centers and smaller community run clinics under NHI, medical services are often applied inefficiently and medical resources are not allocated appropriately. As a proposed solution, it is important to build a physician group practice environment in the form of a community united clinic of which there are currently only a few of in Taiwan. Many studies have shown that community-oriented primary care is more effective in the management of chronic illnesses. In addition to this suggested effectiveness of chronic disease management, a financially sustainable model is also desired under the current form of NHI. In this study I have examined possible factors that are related to the economic performance of a clinic by evaluating the individual work practices of physicians in this clinic. Focusing on more than forty physicians from 2009 to 2012, I were able to deduce an empirical model to assist in future physician recruiting and also design a reasonable salary structure, which benefits both the physicians and the daily operations of the clinic. By building up a community united clinic system, I’ve realized more deliberate and efficient outcomes in the ways that the clinic can be managed and operated. The ultimate goal is to keep patients who are suffering from chronic diseases, within the reach of knowledgeable physicians in their communities, which should lead to improved patient-physician relationships and ultimately would better equip both patients and physicians with the ability to effectively treat specific diseases. The outcome of this would bring cure toward prevention, which was an original purpose of the NHI program.
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