HOME NURSING CARE PROGRAM HARD TO IMPLEMENT IN RURAL AREAS|長照2.0將上路 偏鄉居家醫療有隱憂

Government's ambitious 10-year "long-term care 2.0 plan" is slated to launch within two weeks. However, some doctors believe, the Home Nursing Care Program which is part of the plan will be difficult to implement since transportation may be more difficult to access in rural and remote areas plus the low insurance pay, which are both important factors in attracting medical staff to participate in the program. The 72-year-old Mr. Lu lives in Taitung's Tawu Township, his son has suffered from multiple disabilities and needs to use wheelchair. Every time when they go to hospital for check up, it was quite troublesome. Under the Home Care Program, doctor and nurse drive to patient's home for diagnosis and prescription, it saves patient and family traveling time and trouble. However some doctors worry that inconvenience associates with remote area plus low pay from the National Health Insurance, it can hardly attract medical staff to participating the program. ==YU SHANG-JU, Taitung St. Mary's Hospital Physician== For the chronic illness, doctor said blood sample is required. But you know what? When nurse drew a blood sample, that was not paid; the National Health Insurance only pay for testing fee. When nurse drove one hour to patient's residence, it was neither paid for. Doctors said, 70% of registered patients are seniors whose are 75 years old or older, among them 23% have strokes and lie on beds. The Home Care Program certainly reduces chance of re-admission rate. Doctors urge for more insurance payment points. ==TSAI SHU-LING, Nat'l Health Insurance Adm. Deputy Dir.-General== On April 1 of this year, we started to pay a 1,500-point fee to hospital's discharging patient. The Health Insurance Administration said they will examine the payment system on regular basis; doctor who wants to participate in the program does not need to submit application for approval. If doctor cannot register health insurance IC card on site, he may do so at later time. All those are to motivate more medical doctors participating in the Home Care Program. TRANSLATED BY：ANTHONY LIN 住在台東大武鄉的盧先生已經72歲了，因為兒子有多重障礙、必須坐輪椅，每個月到醫院回診、都要大費周章，幸好現在加入居家醫療照護計畫後，有醫師和護理師到家裡看病、拿藥，讓他省去往返醫院的舟車勞頓，不過有醫師擔心，偏鄉地區交通不便，加上健保給付又少，很難吸引醫療人員投入在宅醫療服務。 ==台東聖母醫院醫師 余尚儒== 慢性病 醫生去了之後說 這個要抽血 可是呢 護理師去抽血 這個也是沒有給付 只有給付檢驗費 護理師去 開車1個小時 也是沒有(給付) 醫師表示，需要居家醫療的病患，有七成是75歲以上長者，其中又以中風最多、占兩成三，因為長期臥床、行動不便，若能提供在宅醫療、定期訪視，臨床上確實可以降低再住院率，因此呼籲健保、檢討健保給付點數。 ==健保署副署長 蔡淑鈴== 我們開始在今年的4月1號 特別支付了一個 1500點的費用給出院準備 對此健保署強調，會定期檢討健保給付制度，至於醫師若擔任居家醫療照護，不需事前向衛生單位核備；健保卡若無法當場登錄，也可事後補齊資料，希望有利於居家醫療服務的推動。 記者 賴淑敏 蔣龍祥 台北報導