Advertisement
Special Issue / Schwerpunkt| Volume 123, P95-98, June 2017

Download started.

Ok

Shared decision making in Taiwan

      Abstract

      The paper aims to introduce the current status of shared decision making (SDM) in Taiwan under its mixed health care system and single-payer health insurance system. With experiences in promoting both evidence based medicine and patient safety, the Joint Commission of Taiwan has implemented a nationwide SDM program under the aegis of the Ministry of Health and Welfare since 2016, incorporating multiple approaches such as developing patient decision aids (PDAs), executing the Medical Decision Aids Campaign, establishing a SDM platform, and integrating SDM in clinical practice. In this article, we share the positive and negative responses to the SDM program from hospitals, health care providers, and patients.

      Zusammenfassung

      In diesem Beitrag stellen wir den aktuellen Stand der partizipativen Entscheidungsfindung (PEF) in Taiwan unter den Bedingungen eines gemischten Gesundheitsversorgungssystems und eines Krankenversicherungssystems nach dem Single-Payer-Modell vor. Auf der Grundlage ihrer Erfahrungen mit der Förderung von evidenzbasierter Medizin und Patientensicherheit hat die Gemeinsame Kommission in Taiwan seit 2016 begonnen, unter der Schirmherrschaft des Ministeriums für Gesundheit und Soziales ein landesweites PEF-Programm zu implementieren, das vielfältige Ansätze wie die Entwicklung von Entscheidungshilfen für Patienten, die Durchführung einer Kampagne zum Thema medizinische Entscheidungshilfen, die Einrichtung einer PEF-Plattform und die Integration von partizipativer Entscheidungsfindung in die klinische Praxis umfasst. Darüber hinaus berichten wir über die positiven und negativen Reaktionen auf das PEF-Programm vonseiten der Krankenhäuser, der Gesundheitsdienstleister und der Patienten.

      Keywords

      Schlüsselwörter

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

      1. Annual report of National Health Insurance , 2016-2017. https://www.nhi.gov.tw/Resource/webdata/13767_1_National%20Health%20Insurance%20in%20Taiwan%202016-2017(bilingual).pdf, 2016. (accessed 2017 March).

        • Reinhardt U.E.
        Humbled in Taiwan.
        BMJ. 2008; 336: 72
      2. Underwood A, Health Care Abroad: Taiwan. https://prescriptions.blogs.nytimes.com/2009/11/03/health-care-abroad-taiwan/, November 3, 2009.(accessed 2017 March).

        • Wu T.Y.
        • Majeed A.
        • Kuo K.N.
        An overview of the healthcare system in Taiwan.
        London J Prim Care (Abingdon). 2010; 3: 115-119
      3. Organisation for Economic Co-operation and Development , Health Care Utilisation. http://stats.oecd.org/, October 7, 2016.(accessed 2017 April).

      4. The Ministry of Health and Welfare, Guidelines of the Protection of Labor Rights, Interests, and Work Hours for the Medical Resident, in 1061661213, The Ministry of Health and Welfare, Editor. March 7, 2017, The Ministry of Health and Welfare,: Taiwan.

      5. Joint Commission of Taiwan , Annual report of Taiwan Patient Safety Improvement Project. http://www.patientsafety.mohw.gov.tw/Content/Messagess/list.aspx?SiteID=1&MmmID=621273300443065506, 2013-2015.(accessed 2017 March).

        • Straus S.E.
        • Ball C.
        • Balcombe N.
        • Sheldon J.
        • McAlister F.A.
        Teaching evidence-based medicine skills can change practice in a community hospital.
        J Gen Intern Med. 2005; 20: 340-343
        • Weng Y.H.
        • Kuo K.N.
        • Yang C.Y.
        • et al.
        Effectiveness of national evidence-based medicine competition in Taiwan.
        BMC Med Educ. 2013; 13: 66
      6. Joint Commission of Taiwan, Report of Implementation of Shared Decision Making Pilot Study, 2015. 2015, Joint Commission of Taiwan: New Taipei City, Taiwan.

        • Legare F.
        • Stacey D.
        • Pouliot S.
        • et al.
        Interprofessionalism and shared decision-making in primary care: a stepwise approach towards a new model.
        J Interprof Care. 2011; 25: 18-25
        • O’Connor A.M.
        • Tugwell P.
        • Wells G.A.
        • et al.
        A decision aid for women considering hormone therapy after menopause: decision support framework and evaluation.
        Patient Educ Couns. 1998; 33: 267-279
        • Huang X.
        • Lin J.
        • Demner-Fushman D.
        Evaluation of PICO as a knowledge representation for clinical questions.
        AMIA Annu Symp Proc. 2006; : 359-363
        • Schardt C.
        • Adams M.B.
        • Owens T.
        • Keitz S.
        • Fontelo P.
        Utilization of the PICO framework to improve searching PubMed for clinical questions.
        BMC Med Inform Decis Mak. 2007; 7: 16
        • Elwyn G.
        • O’Connor A.
        • Stacey D.
        • et al.
        Developing a quality criteria framework for patient decision aids: online international Delphi consensus process.
        BMJ. 2006; 333: 417
        • Elwyn G.
        • Frosch D.
        • Thomson R.
        • et al.
        Shared decision making: a model for clinical practice.
        J Gen Intern Med. 2012; 27: 1361-1367
      7. Joint Commission of Taiwan , Report of Shared Decision Making Entrusted Project, 2015-2016. http://sdm.patientsafety.mohw.gov.tw/Public/Detail?sn=19&id=1215, 2016.(accessed 2017 April).

        • McCaffery K.J.
        • Smith S.
        • Shepherd H.L.
        • et al.
        Shared decision making in Australia in 2011.
        Z Evid Fortbild Qual Gesundhwes. 2011; 105: 234-239
        • Ho A.
        Family and informed consent in multicultural setting.
        Am J Bioeth. 2006; 6 (discussion W27-28): 26-28