從醫療品質潮流看臺北市立醫院的蛻變

Hospital Reform in Taipei and Quality of Care for the 21st Century

柯景塘(Jiing-Tang Ko)

《北市醫學雜誌》 1卷1期 (2004/01) Pp. 113-116

https://doi.org/10.6200/TCMJ.2004.1.1.25

摘要

市醫的改造，應適時納入現代化醫療品質的要求，為了跨越醫療照護與現代化醫療品質的鴻溝，美國Institute of Medicine提出21世紀醫療品質六大目標及醫療照護體系改造十項原則－醫療照護必須是安全（safe）、有效（effective）、以病人為中心（patient centered）、即時（timely）、有效率（efficient）及公平（equitable），並建議從最常見且耗用絕大部分醫療資源的慢性疾病著手，“慢性病管理（chronic disease management）”被認為是未來最有潛力的醫療照護模式－可同時兼顧品質與成本、臨床與公共衛生、治療與預防，慢性病管理應是市醫改造值得採用的策略之一。各醫療科部在規劃未來運作模式時如能參考美國Institute of Medicine六大目標及十項原則，市醫的改造將帶領市醫跨向21世紀醫療品質及醫療照護的新境界。

關鍵字

醫療品質 ； 疾病管理 ； 慢性病 ； 醫院改造 ； 醫院整合

並列摘要

Although Taipei city hospital reform is expecting to overcome the financial deficit, redesign of infrastructure for delivering quality care will be critical for success. The debate and concept of modern care quality are originated from following forces. The new science and technologies of quality measurement and improvement including clinical epidemiology, outcome research and information technology, the changing nature of medical practice due to the changing criteria for optimal care, 15 to 20 chronic conditions that afflict many people and account for the majority of health care resources, and the compelling need to reduce the cost of health care. As the medical science and technology have advanced, however, the health care delivery system has frequently fallen short in its ability to provide consistently high-quality care. To cross the existing quality chasm, Institute of Medicine established six aims for the 21th-Century healthcare quality and formulated ten new rules to redesign and provide quality care. Chronic disease management is the most promising strategy for quality and cost reduction goals. It is also the first choice of strategy for Taipei city hospital consolidation to deliver quality care. Competent information system is the critical element of chronic disease management program. Consolidation of city hospitals to a union hospital is a chance for us to redesign infrastructure with the commitment that quality is the property of our system. To be successful, Taipei city hospital should adopt six aims for quality and ten rules for redesign as matrix of reform.

並列關鍵字

hospital reform ； hospital consolidation ； care quality ； disease management ； chronic disease