衛生資源配置策略－國際發展及對台灣的啓示

Fundamentals of and Strategies for Health Resources Allocation-international Development and Taiwan's Prospects

10.6288/TJPH2004-23-04-03

梁玲郁(Ling-Yu Liang)；黃旭明(Shiuh-Ming Huang)；藍忠孚(Chung-Fu Lan)

衛生資源配置 ； 疾病負擔 ； 健康綜合測量 ； 失能調整人年 ； 公平 ； health resource allocation ； GBD(Global Burden Disease) ； DALYs(Disability-Adjusted Life Years) ； SMPH(Summary Measures Population Health) ； equity

台灣公共衛生雜誌

23卷4期（2004 / 08 / 01）

282 - 291

繁體中文

背景：衛生資源配置雖不是新議題，但在政府財務愈趨緊縮與貧富不均日益嚴重的情況下，此議題日趨重要。決策者需尋求所有可資運用的模式，將有限資源做更有效的配置與應用。 目的：本文乃回顧衛生資源配置之基本理論，並探討近年來國際間再度與起之健康綜合測量的原理方法及其應用，亦分析比較各種評估方法之差異，用以探究台灣現況與問題，並對未來資源配置提出具體可行的建構方向。 結論：台灣目前衛生資源配置仍有相當改善的空間。配置原則除了以各類疾病別、性別及年齡別的流行病學資料為基礎，發展本土化全國疾病負擔外，同時考量實際醫療費用支出、健康公平性原則，與方案執行的可行性，提出衛生資源配置的架構。為促進資源使用效率，以厚植民眾健康，運用模式能因時制宜，做動態的應變，才能隨時達成全民最大的期望。

Background: Issues in Health Resource Allocation (HRA) are not new but are of growing importance. The increasing demands for health care has led policy makers to address this issue more directly than in the past, facing limited government funding and the widening gap between the rich and the poor. Objectives: Fundamental HRA theories are reviewed in this paper. The paper presents the current trend for the summary measures of population health and the methodology used in health outcome measurement. It compares analyses among different evaluation approaches and also evaluates the current government HRA strategies and specifically proposes an outline of HRA for Taiwan. Conclusions: Health care reform is a continuous undertaking. This research developed a modified Global Burden Disease method for the HRA utilizing national epidemiologic data as well as the national health insurance data for Taiwan. This HRA tool shall be modified dynamically over time and with changing locations in order to achieve both efficiency and equity in its application.

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