台湾国民健康保险制度下数字医疗的作用:进展与挑战》。

Health systems and reform Pub Date : 2024-12-17 Epub Date: 2024-10-22 DOI:10.1080/23288604.2024.2375433
Jui-Fen Rachel Lu, Li-Lin Liang
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引用次数: 0

摘要

数字医疗涵盖了数字技术在医疗保健领域的广泛应用。作为支持医疗系统实现其目标--提高医疗服务的可及性、医疗服务的质量和系统效率--的一套新工具,数字医疗极大地改变了现代医学和医疗保健的面貌。本文探讨了数字医疗在台湾国民健康保险中的作用,并考虑了数字医疗在 COVID-19 大流行期间的深远影响。本文特别关注大数据管理和分析(医疗云和我的健康银行/国民健康保险移动便捷通)以及创新服务提供模式(远程医疗)。我们讨论了任何卫生系统都可能遇到的两个迫在眉睫的挑战:数字信任和数字鸿沟。关于数字鸿沟,我们评估了 COVID-19 大流行期间远程医疗的使用情况及其决定因素。我们的研究表明,高收入水平和是否患有慢性病或重病与远程医疗的使用呈正相关。这一观察结果表明,健康状况较差的穷人最有可能出现远程医疗需求得不到满足的情况。加强网络安全以保障保密性,以及与公众进行有效沟通,是在数字时代重新赢得公众信任的基本和必要步骤。在呼吁对数字技术进行更多投资时,政策制定者应注意不同人口和社会经济阶层之间可能存在的数字鸿沟,并应制定具体政策,为社会弱势群体提供支持。
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The Role of Digital Health Under Taiwan's National Health Insurance System: Progress and Challenges.

Digital health covers a wide spectrum of applications of digital technologies in the healthcare field. As a new set of tools to support the health system in achieving its goals-improving access to care, quality of care, and system efficiency-digital health has significantly transformed the landscape of modern medicine and health care. This paper examines the role of digital health under Taiwan National Health Insurance, considering the profound impacts of digital health during the COVID-19 pandemic. It focuses specifically on big data management and analytics (MediCloud and My Health Bank/NHI Mobile Easy Access) and innovative service provision models (telemedicine). We discuss two imminent challenges that any health system is likely to encounter: digital trust and digital divide. For the digital divide, we assessed the use of telemedicine and its determinants during the COVID-19 pandemic. Our study shows that high-income levels and the presence of chronic or severe illness were positively correlated with the use of telemedicine. This observation suggests that poor people who have poorer health status were most likely to suffer from unmet needs for telemedicine. Enhancing cybersecurity to safeguard confidentiality, and effective communications with the public are fundamental and essential steps to regaining public trust in the digital era. When calling for more investment in digital technology, policy makers should be mindful of the potential digital divide across the demographic and socioeconomic strata, and specific policies should be devised to provide support to target the socially disadvantaged group.

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