The role of veterans hospitals in Taiwan's medically underserved areas.

Background: Notable healthcare disparities can be observed in medical services in remote, rural areas with those in urban areas, primarily because of specialist shortages, inadequate healthcare, and poor transportation. Globally, remote and rural areas face economic, health, and service challenges resulting in a shift toward telemedicine and adjusted insurance systems in such areas. In Taiwan, similar problems have prompted initiatives to improve healthcare access and medical capacity, particularly in medically underserved areas (MUAs). We evaluated the healthcare distribution and capacity in MUAs, highlighting the crucial role of veterans hospitals.

Methods: Using government data and a hierarchical approach, we analyzed the distribution of healthcare facilities and professionals, focusing on the effects of the veterans healthcare system.

Results: Taiwan's MUAs face significant health challenges. While they cover 64.9% of the land, they are home to only 10.9% of the population. These areas rely heavily on clinics, while advanced medical facilities and specialists are sparse, particularly in highly remote regions. Public and affiliated hospitals are essential, but insufficient; they face major shortages in emergency medicine, pediatrics, and surgery. Bed utilization rates are lower in highly remote areas (34.9%) compared with remote areas (81.4% in medical centers). Veterans affairs hospitals play a key role contributing 8.9% of the service capacity. However, workforce and resource deficiencies persist, requiring targeted interventions.

Conclusion: Veterans hospitals play an important role in addressing healthcare disparities in Taiwan's MUAs. By supporting emergency care, community education, and workforce development, these hospitals help to improve medical access in remote regions. Facilities, such as the Hsinchu Branch, exemplify this role by enhancing the local service capacity and medical training. Strengthening rural medical education, expanding telemedicine, and optimizing resource allocation are essential strategies for building a more equitable and sustainable healthcare system.