臺灣遠距健康照護文獻中之經濟效益評估探討

A Systematic Review of Cost-Effectiveness Studies of Telehealth in Taiwan

陳威伸(Wei-Shen Chen)

指導教授 ： 許明暉

臺北醫學大學/醫學科技學院/醫學資訊研究所/碩士(2014年)

https://doi.org/10.6831/TMU.2014.00016

摘要

近年來受惠於醫療技術的進步、全民健保的實施與普及，國人平均壽命隨之增加。然而，隨著然而隨著老年人口與老化指數持續攀升、疾病慢性化、長期照護需求增加，卻也對健保財務造成不小的負擔，因此各國無不利用資訊科技的技術，導入遠距照護服務模式，希望能有效節省國家醫療支出、降低民眾經濟負擔。雖然有不少的遠距照護文獻都宣稱其具有經濟效益，然而卻也有部份文獻不約而同地在討論的章節當中提及，除非政府等相關單位持續補助，否則難以長期支持下去，針對此一問題，本研究以(遠距醫療or遠距照護or遠距健康)AND(經濟or成本and效益)做為關鍵字，於臺灣博碩士論文知識加值系統進行檢索，取得國內有關遠距照護經濟效益的相關文獻後，接著利用4種經濟效益分析評估模式：最小成本分析、成本效果分析、成本效益分析與成本效用分析，來逐一檢視相關文獻資料是否符合嚴謹的經濟效益。希望可以利用這樣的評核模式，來了解遠距照護是否真的如同宣稱的那樣具有經濟效益，以供日後進行關於遠距照護經濟效益研究的評估。

關鍵字

遠距醫療 ； 遠距照護 ； 遠距健康 ； 經濟效益 ； 成本

並列摘要

In recent years, the average life expectancy in Taiwan has increased considerably due to advancements in medical technology and the vast medical coverage provided by the National Health Insurance (NHI). However, an aging population with high aging index, high chronic disease prevalence, and increasing long-term care demands, has amounted to a large financial deficit for the NHI. Similar situations have occurred in foreign countries with national health insurance and one of the solutions may be telecare service implementation. Telecare service model employs information technology to track and follow patient welfare, in hopes of reducing the national health expenditure. Although the majority of literature claim that telecare has economic benefits, others have pointed out that telecare is difficult to maintain without constant financial supports from the government and other relevant organizations. In light of these conflicting reports, a systemic review was conducted to shed light on the economic impact of telecare. A literature search query consisting of “telemedicine”, “telecare”, “telehealth”, “economic benefits”, “cost”, and “effectiveness” as keywords was performed in the National Digital Library of Thesis and Dissertations in Taiwan database. Moreover, four methods of economic analysis and evaluation models: Cost Minimization Analysis, Cost Effectiveness Analysis, Cost Benefit Analysis and Cost Utility Analysis were applied to each thesis to thoroughly evaluated the economic impact of telecare. Through these assessments, one may further understand if telecare is indeed as economically efficient as claimed and facilitate future assessment studies on the economic impacts of telecare.

並列關鍵字

telemedicine ； telecare ； telehealth ； economic benefits ； cost

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