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Public Satisfaction with National Health Insurance System Hits Historical High of 89.7%, and Physicians’ Satisfaction with NHI also Increases Year by Year.

  The National Health Insurance (NHI) system has been implemented for 24 years since 1995. To keep abreast of times, various NHI reforms and innovations are being launched on a constant basis. The public satisfaction with the NHI exceeded 80% in 2015 and has been climbing ever since. In 2019, it hit 89.7% (Figure 1), setting a new historical record. NHI is one of the most satisfying policies of Taiwan government. Dr. Po-Chang Lee, Director-General of Taiwan National Health Insurance Administration (NHIA) indicates that there are mainly three factors for the positive and affirmative attitude that our people have towards the NHI. They are “medical accessibility, reduced medical burden, and reasonable premium”, indicating that the NHI system has indeed eliminated the economic barriers for the general public to seek medical attention.


  Today (the 26th) Director-General Po-Chang Lee hosts the wrap-up presentation of the 2019 “Research on the Innovative Model of Developing Data Governance in NHI Services” and announces the survey results on the right of the general public to medical care and the satisfaction of physicians with the NHI system. The research was led by Professor Kuan-Chia Lin at the Institute of Hospital and Health Care Administration, National Yang-Ming University and Associate Professor Yu-Chi Tung at the Institute of Health Policy and Management, National Taiwan University.


  The public NHI satisfaction survey was conducted by the National Yang-Ming University through a model consisting of a digital sentiment analysis system and the dual frame survey approach combining the land-line phone and the mobile phone. Survey results show that over 70% respondents approved the hierarchical medical care policy promoted by the NHI. Further analysis of those indicating disapproval revealed that the key lies in “value”. 70 % of the respondents believed that the services provided by large hospitals is generally more professional and better, and nearly 50% of the respondents were unable to differentiate the severity of disease on their own, which posed the major resistance to behavioral change.

  Professor Kuan-Chia Lin further analyzed the medical care experiences of the nationals over the past five years and found that the biggest core factor affecting people’s satisfaction is the experience they have during a visit. The quality of the trust relationship between the physician and the patient, the transmission of medical care information, and quality of the decision-making and sharing process are all crucial factors affecting the overall feelings of the respondents. Over the past year, among five categories of global budgets, dialysis accounted for the largest portion (up to 78.7%) that healthcare professionals would provide patients with health education, followed by dental services (59.6%), hospital services (59.4%), and clinics services (54.7%). During a visit, “more than 70% of the respondents would discuss care or treatment options with their physician most of the times; among them, hospitals services accounted for the highest portion (up to 83.9%), followed by dental services (83.7%), Chinese medical care services (82.8%), and primary clinics services (81.7%).


  The high level of satisfaction with the NHI among the general public is greatly contributed by the joint efforts of healthcare professionals. Director-General Lee indicates NHIA will continue to find out how the medical professionals/community think about implemented NHI policies, which serve as the basis for communications and administration in the future. The physician satisfaction survey was conducted by Associate Professor Yu-Chi Tung. Physicians were invited to go on line to complete the survey anonymously. Results show that physicians’ satisfaction with the NHI climbed from 17.3% in 2017 to 33.7% in 2019, and dentists’ satisfaction rose from 30.6% in 2017 to 36.6% in 2019. Dissatisfaction appeared to be dropped in both populations, indicating that the attitude of medical professionals/community toward the NHI has been steadily positive (Figure 2).


  Director-General Lee said that the increase in public satisfaction with the NHI and the reduction in dissatisfaction among the physicians show that the efforts made by the NHIA are in line with the physicians’ concerns. In terms of the medical system and payment system, the NHIA implements the hierarchical medical care system and makes hospitals reduce the amount of services provided to those people with minor ailments. The implementation of “Named professional double review” not only reduces controversial review cases but helps develop the mechanism of precision review. The ratio of randomized and purposive sampling cases is adjusted and so is the upper limit of retrospective multiple in global budget payment system.


  The NHI system is based on the triangular interactive partnership among the NHIA, the general public, and healthcare professionals. Voices from both the medical professionals/community and the general public have to be taken into consideration by the NHIA. The NHI in our country is generally recognized by the people. The NHIA will continue to cooperate with the medical professionals/community and listen to the people. All the perceptions and opinions from both the general public and the healthcare professionals about the NHI will be referenced during the planning and implementation of the NHI system.


  The NHIA also applied new technologies and took advantage of the NHI big data to create a people-centered healthcare model by developing two major tools, namely “NHI MediCloud System” and ”My Heath Bank” . The NHIA will continue to join hands with the academic circles and the industries to diversify the NHI big data-based multiple applications, enhance our country’s competitiveness of the digital health, develop innovative services in our society, improve healthcare service quality and develop precision medicine. The NHIA aims to create the new blue ocean in the field of smart health for improving the well-being of people and fulfilling the goal of NHI and health sustainability.

  • Date:2019-11-26