台灣醫療院所記名通報實務與規範研究

我國衛生主管機關藉由公共衛生監測與健康補助計畫，自醫療院所蒐集大量民眾個人資料。公共衛生監測係長期、廣泛、系統性地蒐集資料，除為了立即的公共衛生目的外，並可能長期保存並利用於政策評估或研究。我國公共衛生監測下之強制記名通報，雖然大部分均有法律依據，但在本研究發現的28項監測中，仍有3項規範依據中未明確提及通報系統的建置；而且，僅有6項載明蒐集目的，並普遍無法確實達成授權明確性的要求。另一方面，主管機關透過與醫院訂定行政契約或當事人申請健康補助，獲得大量病患的個人資料，但甚少告知當事人通報事實與蒐集個人資料後的利用情況。我國個人資料保護法對公務機關的個人資料行為規範鬆散，主管機關在組織法的職權下，無須作用法的授權，即可蒐集、處理、利用，甚或蒐集目的外利用民眾的個人資料，甚或建置資料庫提供外部研究使用。本研究透過訪談與規範分析，以了解我國醫療院所受記名通報之實務與規範情況，最後建議修正個人資料保護法，強化對公務機關蒐集、處理、利用個人資料之規範密度。

關鍵字

公共衛生監測；記名通報；強制通報；個人資料保護法

並列摘要

Public health authorities collect large amounts of personal information from medical institutions through name-based reporting; this collection is facilitated by public health surveillance and medical subsidy plans. Public health surveillance involves the continual, general, and systematic collection of personal information. Collected information is not only used in efforts to achieve immediate public health goals but also preserved for long-term usage such as policy evaluation and research. In this study, we observed 28 name-based-reporting systems used in public health surveillance in Taiwan. Ostensibly, all these systems are legally authorized; however, three have not been mentioned in any legal articles. Only the six of these systems state the purposes for data collection in the authorization provisions. Most of the authorization laws do not include required details regarding system regulation. On the other hand, public health authorities offer subsidies to medical institutions and patients through contracts and receive enormous amounts of personal medical information from reimbursement. Under the Personal Information Protection Act in Taiwan, the government agencies possess the authority to collect and process people's personal information from organization laws. In the absence of specific regulations, government agencies may legally use collected data of relevant individuals without informed consent for purposes not specified in the data collection terms. For example, information may be used to establish a database for academic research. This study explored the regulations and practices of name-based reporting in Taiwan by conducting interviews and analyzing the relevant laws and regulations. The results of this study suggest that the government should revise the Personal Information Protection Act to establish comprehensive regulations for name-based reporting.