Description

Wei Wei Hsia - Strategies of Promoting Tiered Healthcare System Using the Analytic Hierarchy Process and Stakeholder Analysis

Taiwan’s National Health Insurance has been implemented since 1995 as a compulsory welfare policy. It was designed as a tiered medical services: clinics in each community provide L1 medical care, medium-sized hospitals provide L2 medical care and the large hospitals provide L3 medical care. However, the tiered medical system has never been implemented successfully. Even minor illnesses are concentrated in large hospitals for medical treatment, causing medical waste, harming the interests of critically ill patients, and poor medical quality. After many failures, in 2017 the Ministry of Health and Welfare announced the "6 Strategies and 24 Measures to Promote the Tiered Healthcare System", but the results were still very limited. Then, in the case of serious conflicts of interest among stakeholders, how can these strategies been promoted effectively? The purpose of this research is to use both the analytic hierarchy process (AHP) method and the stakeholder theory to set the priority order and complementary plans for the 24 measures. This study is aimed to resolve the problem and give a holistic view on the 24 measures by using the AHP hierarchy analysis and the Mendelow's Matrix method. In the end, the study identified the key factor that has failed the previous promotion of tiered medical care is the lack of key players in the game. Therefore, it is proposed to "strengthen the interests of the Ministry of Health and Welfare to really implement tired medical care", and to "subsidize the employed doctors, large hospitals and medium-sized hospitals”.