• Jien-Wen Chien, Chi-Hsin Sally Chen, and Yi-Jung Chen.
• Department of Pediatric Nephrology, Changhua Christian Children's Hospital, Changhua, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan; Department of Pediatric Nephrology, China Medical University Children's Hospital, Taichung, Taiwan. Electronic address: 019261@tool.caaumed.org.tw.
• J Formos Med Assoc. 2024 Sep 18.

AbstractDuring the COVID-19 pandemic, Taiwan's pediatric healthcare system faced its most severe shortage of pediatric residents in history. This review investigates the causes, consequences, and potential solutions to this shortage. Between 2020 and 2023, the recruitment rate of pediatric residents dropped by 27.3%, increasing workloads for attending pediatricians and may worsening health outcomes for pediatric patients. Compared to South Korea and Japan, Taiwan has the highest neonatal mortality rates and lowest life expectancy at birth. Additionally, Taiwan's National Health Insurance (NHI) pays pediatricians in hospitals half of what it pays those in local clinics, hindering the attraction of pediatric hospitalists. To sustain the pediatric healthcare system, the government could consider directly compensating pediatricians at clinic rates and transitioning to a capitation payment system. Systemic recommendations include increasing health expenditure as a percentage of gross domestic production (GDP) and amending the NHI Act to eliminate the global budget payment system. Managing the resulting increase in financial responsibility could involve raising tax revenue as a percentage of GDP. Implementing these measures could strengthen the pediatric healthcare system and prevent a collapse of pediatric inpatient care.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

15 keywords...

hide…