影響健康的因素相當複雜,透過疾病治療與個人行為的改變已不能全面達到促進健康的目的。世界衛生組織於1986年發表渥太華憲章,強調藉由建立健康的支持性環境,以及透過醫療服務體系的重整,從整體生態性的觀點改善人們的健康狀況,健康醫療環境的發展對促進人們的健康將有更積極的意義。台北市於民國91年11月首度舉辦健康醫院評鑑,並以減重、運動、飲食及戒菸等四項健康主題為評鑑重點,加深了政府單位對醫療機構健康環境之重視。然而,台灣目前對健康促進醫院的概念尚且模糊,在大家普遍未有深刻的認知及詳細的規劃前即加以推行,是否會與國際間推行的健康促進醫院理念有所出入?是否能永續經營?這些都是值得深入探討的議題。因此,本文的主要目的是探討國際間健康促進醫院的理論及發展背景,並根據澳洲昆士蘭省推行健康促進醫院的實際經驗,探討其計畫推行的過程及成效,以及對台北市推行的「健康醫院評鑑」提出相關建議。本文採用文獻探討方式,探討國際間推行健康促進醫院的相關文獻,具體瞭解健康促進醫院的內涵,以作為我國發展健康促進醫院的參考。本文經深入探討後發現,台北市雖有推行健康促進的決心與初步計畫,但推動「健康醫院評鑑」之基礎缺乏理論的建構,且推動議題的選擇是由上而下的決策模式,缺乏以民眾的需求評估為導向的健康議題優先選擇方式;此外,本文也針對台北市的「健康醫院評鑑」的內容,提出改進的建議,希望能讓健康醫院評鑑的發展更具意義,且能永續經營。
The hospital place is an important setting which impacts on the social, mental, and physical well being of the staffs and communities. Historically hospital services have been concerned with treatment of disease in individuals rather than health promotion in populations. In recent times the role of hospitals has been expanded to include health promotion as one component of primary level care. Healthy Promoting Hospital (HPH) represents a focal point in the changing direction of health care. A HPH environment can induce many positive changes such as, a healthier workforce, increased morale, reduces absenteeism and, in turn, increased productivity and community health. The field of HPH has developed and gains momentum in Taipei City since 2001. It has undergone a significant evolutionary process, one which is still not generally understood. The aim of this paper is to examine the theory to reality in relation to HPH and review the current Healthy Hospital Accreditation policy in Taipei City. While the example given relate specifically to Queensland, Australia, the processes and activities have general relevance and may be adapted to Taiwanese hospital settings.