台灣社區醫療防疫體系的過去、現在及未來

台灣百年來醫者關懷和社會情懷永遠不變，台灣醫界面臨全民健保制度、醫療體系重整、國際情勢的挑戰，加上人工智慧發展，如何堅守醫療核心價值值得研議。台灣近代史第一次社區醫療革命，就是民國72年開始，在醫療資源不足鄉鎮設立群體醫療執業中心。1999年發生921震災，後來2003年SARS之後推展社區防疫群是第二次革命，在COVID-19的挑戰也成為防疫體系基礎。第六期醫療網建立分級醫療體系健康照護醫療網的架構，社區醫療群除了提高預防保健等，也減少健保花費。另外，對於是否願意提供COVID-19防疫工作，有參加社區醫療群計畫的醫師，其意願高很多。醫師公會全聯會定期召開各縣市及全國性COVID-19防疫應變視訊會議，穩住全國醫界防疫的決心，也建構社區分級防疫網絡的規劃。蔡英文總統期許台灣建構健康防疫安全網，這正是醫界未來的工作目標。

關鍵字

新型冠狀病毒；社區醫療；防疫

並列摘要

For more than 100 years, physicians in Taiwan remain wholeheartedly dedicated to the care for our society. As health professionals we now face many challenges. With changes in our national health insurance strategies, restructuring of our healthcare system, difficulties with our international relations, and the emergence of artificial intelligence in medicine, we need a serious discourse on how to keep our core values intact as healthcare providers. The Group Practice Centers, first set up in rural areas in 1983, ignited the first revolution in community medical care. The second revolution took place as community healthcare groups emerged in response to the 921 Jiji earthquake in 1999 and the SARS epidemic in 2003. These innovations provided a strong foundation enabling Taiwan's extraordinary response to the COVID-19 outbreak in 2020. The national project of sixth stage medical care network provided the backbone of a hierarchical medical system. Community Healthcare Groups deliver preventive care and lower medical expenses. Furthermore, physicians are more willing to participate in the control of COVID pandemic if they are part of a community healthcare group. The Taiwan Medical Association (TMA) holds virtual meetings with regional associations regularly to gather information about COVID 19 nationwide and refine our response strategies. The leadership of TMA is determined to construct safety networks for national health, a key objective charged by President Tsai. This will continue to be a high-priority mission in the near future for TMA.

並列關鍵字

COVID-19 ； community medicine ； epidemic prevention

參考文獻

Chang BB, Chiu TY. Ready for a long fight against the COVID-19 outbreak: an innovative model of tiered primary health care in Taiwan. BJGP Open 2020;4(2):bjgpopen20X101068.

邱泰源、陳石池、黃天祥：攜手走過921：建構社區醫療體系。台北市：國立臺灣大學醫學院，2003。