Taiwan Eyes Home Cancer Chemotherapy Amid Insurance Hurdles

Taiwan's Ministry of Health and Welfare is pushing for home-based cancer chemotherapy to alleviate hospital bed shortages and enhance overall medical service efficiency. However, a significant hurdle is insurance coverage, as many existing cancer insurance policies stipulate hospitalization for claims.

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The tests are on the tissue, not the patient, but this occupies a hospital bed, which is unreasonable.

To address this, the ministry plans to engage with the Financial Supervisory Commission and insurance companies. Discussions will focus on developing new insurance products that cover home-based medical care and new care models, as well as adjusting current policies. The goal is to create a win-win situation for patients, insurers, and healthcare providers.

Taipei Medical University Hospital President Yu Chung-jen highlighted that current commercial insurance and the National Health Insurance's Diagnosis Related Groups (DRG) system often tie benefits to hospitalization. This can lead to patients requesting admission solely for insurance claims, even when outpatient care or day surgery would suffice. He pointed out that tests like next-generation sequencing, crucial for cancer treatment, often analyze tissue samples or blood, not requiring inpatient care.

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When promoting home-based treatment in the past, the ministry received feedback from frontline hospitals that patients refused due to insurance coverage issues, making it difficult to promote home-based treatment models.

Yu emphasized that as medical technology advances, many treatments previously requiring hospitalization can now be done on an outpatient basis or through day surgery, citing cataract and some hemorrhoid surgeries as examples. Expanding this model, potentially including some cardiac catheterization procedures, could free up hospital beds and improve patient flow, especially amid nursing shortages and rising bed demand.

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The medical costs of introducing home-based models are lower than inpatient models, and bed utilization efficiency has also improved, helping to alleviate hospital staffing shortages and high bed demand.