Premier urges strict execution of measures to tackle ER overcrowding

Taipei, Feb. 27 (CNA) Improvement measures proposed by the Ministry of Health and Welfare (MOHW) to address the ongoing crisis over overcrowded emergency rooms (ER) need to be strictly implemented, Premier Cho Jung-tai (卓榮泰) said Thursday.

Amid the severe ER overcrowding that has been seen across Taiwan since the Lunar New Year holiday, Health Minister Chiu Tai-yuan (邱泰源) on Monday proposed five measures to address the problem, including instructing medical centers to improve inpatient bed allocation and strengthen coordination among regional hospitals.

Speaking at a news conference, Cabinet spokesperson Michelle Lee (李慧芝) relayed that Cho had instructed the MOHW to strictly implement the improvement measures during the Executive Yuan meeting on Thursday.

Cho hopes that hospitals that have already implemented the improvement measures will continue to do so and that the measures will be expanded to other hospitals to enhance patient triage systems, according to Lee.

Meanwhile, Kao Ching-chiu (高靖秋), convener of the board of directors at the Taiwan Union of Nurses Association (TUNA), told reporters that long work hours, low wages and poor working conditions have led to the continuous loss of nursing staff in different hospitals, which in turn has contributed to ER overcrowding.

Kao said that the TUNA has proposed six measures to tackle the high turnover of nurses, including a government-funded monthly additional allowance of NT$10,000 (US$304) for hospital nurses performing clinical duties, to be provided until the nursing workforce recovers.

Another measure is to increase inpatient nursing fees for patients admitted through the ER and requiring a hospital bed, Kao said, adding that such adjustments also seek to better reflect the professional value of nursing.

The National Health Insurance Administration (NHIA) has also proposed measures to raise salaries for doctors and nurses to prevent turnover, including separating ER nursing fees from ER consultation fees, with both being charged separately according to triage classification, NHIA Director-General Shih Chung-liang (石崇良) told reporters on Wednesday.

In addition, Shih noted that the current National Health Insurance (NHI) system only covers nursing fees and excludes physician consultation fees for doctors and nurses caring for patients requiring a bed for observation after being admitted through the ER.

The NHIA plans to increase nursing fees and introduce new physician consultation fees for medical staff handling observation beds allocated to patients transferred from the ER, Shih added.

Deputy Health Minister Lin Ching-yi (林靜儀) said Monday that the median number of patients waiting for beds in the ER over the past 60 days has ranged from around 55 to 65 in medical centers at any given time, with a few hospitals consistently exceeding 100.

In terms of frontline observations, Chen Liang-fu (陳亮甫), an attending physician in emergency medicine at a Taipei medical center, told CNA on Wednesday that since the second half of last year, the waiting time for admission has been three to five times longer than previously.

In the past, when admissions were decided in the morning, patients could usually be transferred to a ward by the afternoon, Chen said.

"But now, the process takes around three to five days," he said, adding that the longest wait time he has encountered was seven days.