美國開放式醫療制度應用於臺灣之整合分析研究

Meta-Analysis of the Application of the US Open-Panel Healthcare System in Taiwan

林以祥(Hsiang Lin) ； 王宗曦(Tsung-Hsi Wang) ； 白佳原(Jar-Yuan Pai)

《澄清醫護管理雜誌》 15卷1期 (2019/01) Pp. 50-57

摘要

參照美國所實施之開放式醫療制度，借鑒其醫院和開業醫師間的規範及運行模式，考量醫療體系之可執行度及開放式醫療制度在臺灣醫師制度上可採用之規劃，針對臺灣醫療制度下醫師及醫療院所面臨之問題提出改善方案，作為提供相關決策單位作為參考之依據。本研究採用文獻回顧法，文獻來源以美國政府公開資訊及與開放式醫療制度之相關研究文獻，並邀請美國及國內相關專家學者進行專家會議研討，針對本研究所彙整之美國開放式醫療制度相關文獻資料，客觀探討美國開放式醫療制度應用於臺灣醫療制度現況之可行性。美國開放式醫療制度特點為醫院及醫師為簽約之合作關係，簽約內容由開業醫師與醫院協調達成共識，亦可協調關於當急診部門人手不足時可調動或聯絡開業醫師支援，在急診室及加護病房也會有醫院之醫師值班。依據美國開放式醫療制度運作模式，臺灣醫院可與開業診所醫師簽約，簽約內容及所需互相配合之醫療服務事項皆由開業醫師與醫院協調達成共識，同時亦可協調關於當急診部門人手不足時可調動或聯絡開業醫師支援，以解決醫療人力不足之狀況。

關鍵字

開放式醫療制度 ； 醫療人力資源 ； 美國醫療保險

並列摘要

After referring to the US open-panel healthcare system with its specifications and operating modes between hospitals and medical practitioners and considering its enforceability and programs applicable to the Taiwan healthcare system, improvement plans that can be used as references for relevant decision-making units have been proposed for problems faced by physicians and medical institutions in Taiwan. In this study, we carried out a literature review on public information from the US government and research articles related to the open-panel healthcare system. We also invited experts and scholars from the US and Taiwan to objectively discuss the feasibility of applying the US open-panel healthcare system in Taiwan based on relevant literature compiled in this study. The US open-panel healthcare system is characterized by contractual cooperation between hospitals and physicians whereby the details of the contract should be agreed upon by both parties. The system also allows the coordination of support from medical practitioners when the emergency department is understaffed. In addition, there are physicians on duty in emergency departments and intensive care units. Based on the operating mode of the US open-panel healthcare system, hospitals in Taiwan can sign contracts with medical practitioners whereby the details of the contract and relevant healthcare services are agreed upon by both parties. These contracts allow the coordination of support from medical practitioners when the emergency department is understaffed to solve the shortage of human resources in healthcare.

並列關鍵字

Open-panel healthcare system ； Human resources in healthcare ； US health insurance