中醫醫院對健保住院業務之意見調查

AN OPINION SURVEY OF IN-PATIENT SERVICE COVERAGE UNDER THE NATIONAL HEALTH INSURANCE PROGRAM AT TRADITIONAL CHINESE MEDICINE HOSPITALS IN TAIWAN

全民健保法雖然已經將中醫住院納入給付範圍，但迄今仍未獲開辦，為了提供政府及醫院管理者政策擬定之參考，本研究於1996 年對全省89 家中醫醫院進行意見調查，共回收49 份問卷，回收率55% 。經統計分析獲致下列結論：1. 絕大多數中醫醫院都贊成實施評鑑，並以評鑑合格作為承辦健保中醫住院業務的資格。2. 未來中醫住院業務應包括中醫傷科、中醫內科、中醫針灸科及中醫婦科，並優先將X 光、血、糞、尿常規檢查及血生化檢查納入給付項目。3. 醫療法中有關中醫醫院設置標準之藥師人數應為醫師人數1/2 以上，大多數的醫院都認為此項規定對中醫醫院過於苛求。4. 大部份的醫院都認為應該准許中醫醫院聘請西醫協助住院病患之急救工作，又目前具有雙重中西醫資格者只能擇一登錄執業，且中醫醫院不得設置西醫科別，此等限制不利於中醫之健全發展，建議及早修法，以符合實際須要。By law, in-patient services using traditional Chinese medicine (TCM) were to have been covered by the National Health Insurance (NHI) Program. However, this was never implemented. In the present study, we conducted a survey among 89 TCM hospitals in Taiwan on this issue. We received 49 surveys back, which was a return rate of 55%. The survey results showed the following consensus: 1.TCM hospitals should be accredited and provide in-patient services accordingly. 2.TCM hospitals should have trauma, internal medicine, acupuncture, and gynecology departments. They should also be allowed to employ western physicians to perform routine exams, such as X-ray, blood, stool and urine tests which are paid for by the NHI. 3.The current rule that the number of pharmacists in TCM hospitals must exceed half the number of doctors is too restrictive. 4.TCM hospitals should be able to recruit physicians licensed in Western medicine for their emergency departments. Current restrictions, such as the rule that physicians holding both Western and Chinese medical licenses can only use one license, and the prohibition on the establishment of Western medical specialties in TCM hospitals, are not beneficial to the development of TCM. We suggest that the government amend the regulations related to TCM hospitals to help further the development of TCM in Taiwan.