偏遠地區醫事人力解決方案之探討

Health Care Professionals in Rural Areas

譚秀芬(Hsiu-Fen Tan) ； 曾泓富(Hung-Fu Tseng)

《醫務管理期刊》 4卷2期 (2003/06) Pp. 26-36

https://doi.org/10.6174/JHM2003.4(2)26

摘要

台灣長期以來利用各種方案與政策試圖解決偏遠地區醫事人力不足的問題，本文主要目的在描述與探討美國、加拿大、日本及我國重要的偏遠地區醫事人力解決策略，包括一、滿溢策略，二、情感認同策略，三、經濟誘因策略，四、公費醫師策略，五、移民策略，六、多重訓練策略及七、支援醫院策略。針對各國在各項策略的應用方式與其優劣加以討論。本文建議未來台灣在規劃偏遠地區醫事人力上應重新規劃檢討醫療照護財務的劃分方式，加強倚重非醫師的醫事人力從事偏遠地區的第一線醫療照護，重新擴大與加重醫學教育在偏遠地區醫事人力培育的責任，並加強落實支援醫院在偏遠地區的醫療角色。

關鍵字

偏遠地區 ； 醫事人力 ； 衛生政策

並列摘要

The shortage of health care professionals in rural areas has long been an important issue for government authority. We reviewed and discussed important strategies and policies dealing with the supply of health care professionals in rural areas in several countries, including Taiwan, United States of America, Canada, and Japan. These strategies included: 1. market saturation strategy; 2. affiliation strategy; 3. economic incentive strategy 4. medical scholarship program: 5. foreign physician immigration program: 6. multidiscipline strategy; and 7. supportive hospital strategy. We suggested that when planning the supply of health care professionals in rural areas, focus should be given to the financial arrangement of the special supportive program, the usage of non-physician health care professionals in primary care in rural areas, the reinforcement of the responsibility of medical education in training health care professionals for rural areas, and the importance of the supportive hospital in providing health care services to rural areas.

並列關鍵字

Remote area ； Medical ； Medical manpower ； Health policy

參考文獻

American Academy of Physician Assistants(1998).Estimated number and percent distribution of clinically practicing physician assistants at yearend 1997 by state.

Federal/Provincial/Territorial Advisory Committee on Health Human Resources

Cawley, J. F.,Osterweis M,McLaughlin CJ,Manasse HR （eds.）(1996).The US Health Workforce: Power, Politics, and Policy.Washington, DC:Association of Academic Health Centers.

Department of Health(2000).Taiwan Public Health Report.Taipei:Department of Health Taiwan.

Enhancing health services in remote and rural communities of British Columbia. Ministry of health Services