推動高價值醫療之策略的國際發展與北市聯醫的經驗

Strategy for Promoting High-Value Health Care: Global Development and Experience of the Taipei City Hospital

王實之(Shih-Chih Wang) ； 劉嘉仁(Chia-Jen Liu) ； 吳怡伶(Yi-Ling Wu) ； 趙康邑(Kang-I Chao) ； 黃遵誠(Tsun-Cheng Huang) ； 黃勝堅(Sheng-Jean Huang)

《北市醫學雜誌》 14卷附冊 (2017/11) Pp. 1-16

https://doi.org/10.6200/TCMJ.2017.14.SP.01

摘要

如何創造出高價值的醫療照護體系是目前全球共同面對的問題。雖然目前台灣的全民健保制度在國際間頗獲好評並且提供出不錯品質的服務但不一定創造出高的價值。本文主要的目的在探討所謂的高價值醫療應當如何在社區醫院中落實，以及如何在現有的醫療體系中進行典範的轉移—即，從零和競爭的觀念轉變到為病人創造價值。除了回顧現有的文獻也描述歸納臺北市立聯合醫院在推動、傳播以價值為基礎的健康照護理念上的策略與方法。本文建議高價值的醫療服務應該由醫生和病人共同創造出來，提高病人的健康識能鼓勵病人對照顧計畫的參與改善醫病的溝通互動、減低家屬的負擔，才能提升醫療品質讓病人得到更好的健康、醫病關係更融洽，也使社會更和諧。

關鍵字

價值醫療 ； 健康識能 ； 醫病溝通 ； 以病人為中心 ； 臺北市立聯合醫院

並列摘要

How to create a high value healthcare system has become a global issue nowadays. Although the Taiwan National Health Insurance is recognized for its favorable comments on international stage, it does not necessary imply a simultaneous creation of high value care. This research aims to discuss how the so-called high value healthcare may be implemented in community hospitals and be proceeded with a paradigm shift, which mean changing from a zerosum game to pursuit of value for patients. Beside from literature review, this paper describes and analyzes the strategies and methods adopted by the Taipei City Hospital in the promotion of value-based healthcare. We suggest that the high value medical service should be created together by both doctors and patients. It is necessary to enhance patients' health literacy, encourage patients to participate in their healthcare plan, improve the communication between doctors and patients, and reduce burden of the family members. Only then the care quality can be elevated and consequently the patient health, so as the doctor-patient relationship and the harmony of society.

並列關鍵字

Value-based healthcare ； health literacy ； doctor-patient communication ； patient-centered ； Taipei City Hospital