Department of Oral Health, Ministry of Health and Welfare, Taiwan.
Department of Health Care Administration, Chang Jung Christian University, Taiwan.
J Formos Med Assoc. 2024 Nov;123 Suppl 3:S157-S162. doi: 10.1016/j.jfma.2024.09.039. Epub 2024 Oct 5.
This paper examines the resilience of Taiwan's oral healthcare system in response to COVID-19, focusing on pre-pandemic conditions, pandemic impacts, and policy recommendations for future resilience. In Taiwan, oral diseases were prevalent, with 80.48% of adults affected by periodontitis in 2016, and 65.43% of 5-year-old children experiencing dental caries. Taiwan's National Health Insurance (NHI) covers over 99% of the population, providing comprehensive dental care. The global budget (GB) payment system, implemented in 1998, ensured financial stability. During the pandemic, dental visits in Taiwan decreased by 5.1% in 2021 compared to 2019. Despite reduced visits, the GB system maintained financial stability, mitigating financial impacts on healthcare institutions. The pandemic generally negatively affected healthcare workers' well-being, increasing resignation intentions. However, the number of practicing dentists in Taiwan remained stable from 2016 to 2022, with slight increases. Urban-rural disparities persisted, and workplace transitions increased, indicating greater mobility among dental professionals. To enhance resilience, the following recommendations are proposed: 1. Strengthen hierarchy of oral healthcare system: Balance dental resources across regions, and improve referrals between hospital and clinics; 2. Provide integrated patient-centered care: Integrate oral health into disease prevention and offer comprehensive services across all stages of life; 3. Integrate digital technology: Promote teledentistry and leverage Taiwan's strengths in information and communication technology (ICT).
本文考察了台湾地区口腔医疗体系在应对 COVID-19 时的韧性,重点关注大流行前的情况、大流行的影响以及未来韧性的政策建议。在台湾,口腔疾病较为普遍,2016 年牙周炎影响了 80.48%的成年人,5 岁儿童中有 65.43%患有龋齿。台湾的全民健康保险(NHI)覆盖了超过 99%的人口,提供全面的牙科护理。1998 年实施的总额预算(GB)支付制度确保了财务稳定。在大流行期间,台湾的牙科就诊量在 2021 年比 2019 年下降了 5.1%。尽管就诊量减少,但 GB 制度仍保持了财务稳定,减轻了对医疗机构的财务影响。大流行通常对医护人员的幸福感产生负面影响,增加了辞职意向。然而,台湾的执业牙医数量从 2016 年到 2022 年保持稳定,略有增加。城乡差距仍然存在,工作场所的流动增加,表明牙科专业人员的流动性更大。为了增强韧性,提出以下建议:1. 加强口腔医疗体系的层级结构:平衡各地区的牙科资源,并改善医院和诊所之间的转诊;2. 提供以患者为中心的综合护理:将口腔健康纳入疾病预防,并在生命的各个阶段提供全面的服务;3. 整合数字技术:推广远程牙科,并利用台湾在信息和通信技术(ICT)方面的优势。