檢視我國均衡區域病床資源之發展政策

Development policy of balancing the number of hospital beds among regional area in Taiwan

吳肖琪(Shiao-Chi Wu) ； 葉馨婷(Shin-Ting Yeh)

《台灣公共衛生雜誌》 41卷2期 (2022/04) Pp. 128-141

https://doi.org/10.6288/TJPH.202204_41(2).110143

摘要

醫療網計畫為均衡區域醫療資源分布，減少民眾就醫距離之障礙，因此將台灣地區劃分為17個醫療區域。本文系統性回顧政府推動醫療網計畫以來在均衡區域醫療資源政策之脈絡；研究結果發現，我國二級醫療區內每萬人口總病床數之最高值與最低值差距比有縮小，一級醫療區內之醫學中心家數、及二級醫療區域內之區域醫院家數多已超過醫療網設定，自2010年公告發布「醫院設立或擴充許可辦法」，僅保留對醫療資源過剩區之絕對擴建限制，三級醫療之病床目標值逐步放寬致更難落實分級醫療。未來50年我國總人口數將持續減少，除將使每萬人口病床數持續增加，都市化效應亦將使農業縣市人口加速流失，恐造成農業縣市之基層健康照護單位及人力難以續留，建議未來仍需持續管控區域級以上醫院之床數變化，並強化農業縣市基層健康照護單位及人力之量能，以避免影響民眾就醫可近性。

關鍵字

醫療網計畫 ； 區域病床 ； 醫療區域 ； 分級醫療

並列摘要

The Medical Care Network Plan divided Taiwan into 17 medical areas to balance medical resources and reduce distance-related barriers to access. This paper presents a systematic review of how regional medical resources have been balanced since the Medical Care Network Plan was established. The gap between the highest and lowest total number of beds per 10,000 people in secondary medical areas has narrowed. The number of medical centers in the primary medical areas and the number of regional hospitals in secondary medical areas have exceeded plan targets. The ＂Permission for Hospital Establishment or the Expansion of Licensing＂ measures announced in 2010 only retain absolute expansion restrictions with excess medical resources. As the target number of tertiary medical beds is gradually relaxed, the implementation of a hierarchical medical care policy becomes more difficult. In the next 50 years, the total population of Taiwan is expected to continue to decrease. In addition to the continual increase in the number of hospital beds per 10,000 population, urbanization effects will accelerate population losses in agricultural counties and less-populated cities, making it difficult for primary health care units and personnel to remain there. Changes in the number of beds in hospitals above the regional level must continue to be controlled, and the capacity of grassroots health-care units and human resources in agricultural counties and less-populated cities must be increased to avoid reducing the public's medical treatment accessibility.

並列關鍵字

Medical Care Network Plan ； regional hospital bed ； medical areas ； the hierarchy of medical care policy

參考文獻

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