Oral Poster Presentation

3 - Challenges in Sustainability of Taiwan Government’s Fully Funded Emergency Air Medical Services (EAMS)

Tuesday, October 25, 2022

11:00 – 11:20

Location: Expo Hall Theater

First Author(s)

Wan Lin Chen, MD

Dr
Taipei Medical University
New Taipei City, Taiwan (Republic of China)

Second Author(s)

Hon Ping Ma, MD

Dr
Shuang Ho Hospital, United States

Third Author(s)

Wen Ta Chiu, MD

Dr
AHMC HealthCare, United States

Fourth Author(s)

Shin Han Tsai, MD

Dr
Taipei Medical University, United States

Introduction: Air medical transport for both prehospital and interhospital missions in Taiwan has been fully managed by the government.
Since its introduction in 1995, the Taiwan’s National Health Insurance (NHI) program has won widespread public approval for its accessibility and convenience. However, due to an aging population and the resulting increase in chronic diseases, new technologies for medical treatment, and the resistance to
adjusting the premiums, medical expenditures have outgrown the revenue generated from the premiums collected. To ﬁnancially stabilize the NHI while developing the healthcare system so that it provides optimal medical services for the people of Taiwan, the National Health Insurance Administration (NHIA) has taken several measures to slow the growth of medical expenditures. These measures include the Taiwaneseversion of Diagnosis-Related Groups payment system, reducing the discrepancies between NHI drug expenditures and hospital purchase prices, and the implementation of a global budget system. To enhance the effectiveness of insurance beneﬁts, the Administration has sought to reduce the unjustiﬁed use of medical resources to ensure the appropriate allocation of the limited NHI resources.

The geographical limitations in Taiwan and unequal development of medical manpower and facilities on remote islands pose great challenges in growing need of medical transfers to the main island of Taiwan.

Methods: A retrospective analysis was done by analyzing the NAAC databank. This study was approved by institutional review board (IRB) of Taipei Medical University.

Results: Between October 01, 2001 and June 30, 2022, there were 6,644 EAMS (avg 24.93/month). Among them 5,895 were interfacility transfers. A total of 5,182 interfacility transports were approved, with an approval rate of 87.91%.
Among all airlifted patients, male outnumbered female (M:F=2:1). However, the average age of patients significantly increases year on year. Age group of over 60 years comprised the majority of cases.EAMS in Taiwan is fully funded by the government. Financially, the establishment of NAAC saved government budget of 18 billion NTD (about 6 millions USD.) in the past 19 years.

Conclusion : As general population ages, current healthcare system in Taiwan has increasing percentage of expenses in caring for elderly patients with multiple co-morbidities and increased care needs. With the expansion of coverage, it will inevitably have an impact on every aspect, including air medical transport. Under the current NHI program, the number of patient transports increases and it will worsen an existing financial burden in current reimbursement mechanisms. The impact of Taiwan NHI program on EAMS needs further study to evaluate the appropriateness of resources allocation.