台灣遠距醫療未來遞送模式之探討

The Future Telemedicine System in Taiwan: A Lesson from Past 9-year Experience

10.6160/2004.12.19

譚秀芬(Hsiu-Fen T. Tan)；吳明容(Ming-Ron Wu)；曾泓富(Hung-Fu Tseng)

遠距醫療 ； 成本分析 ； 偏遠醫療 ； 政策評估 ； Telemedicine ； Cost analysis ； Remote health ； Policy evaluation

中山管理評論

12卷6期（2004 / 12 / 01）

65 - 91

繁體中文

台灣遠距醫療進行了已近十年，衛生署補助的計畫經費超過兩億，會診總次數僅近九千。偏遠地區因遠距醫療受益了嗎？遠距醫療的執行成果合理嗎？本研究即對台灣地區遠距醫療先導應用計畫進行成本分析評估。由於病患之就醫資料取得困難，為求盡量精確推估各項成本，本研究以遠距醫療的執行中心會診人次為計算基礎，摩擬該群病患四種不同的就醫模式，進行成本比較。儘管遠距醫療成本驚人，會診人次逐年漸減，平均每個連結點的執行人次數大幅下滑近80%，但從成本比較中發現，若非計畫經費如此之高，遠距醫療相較於鄉外就醫事實上是可以節省就醫成本。且若越多比例的鄉外就醫民眾轉而使用遠距醫療，則可能降低的成本越多。未來遠距醫療應與現有偏遠地區醫療遞送系統結合，成為台灣偏遠地區常態之醫療利用模式，以期能降低成本、提高利用。

It has been almost ten years since the beginning of telemedicine application system in Taiwan. Although the overall investment reached 200 million NT dollars, the total number of visits seen by the system was only around 9000 times. Is this system really helpful or is the investment reasonable? The purpose of this study is to analyze the cost of telemedicine application system in Taiwan over the past nine years. Data from the Department of Health and the final running reports from five medical centers were analyzed to compare the potential costs of four different delivery models. Despite of the surprisingly huge investment, the usage of the system declined every year. The average number of visits of each connecting point has declined 80% since the beginning. However, if running costs of the system could be neglected, the cost associated with each telemedicine visit has been shown to be less than that of out-village visit. Therefore, if the usage of the system can be increased, the overall costs of delivering health care services to remote areas can be reduced. The telemedicine application system can be integrated into the remote health delivery system in Taiwan to further lower the running costs and efficiently increase its utilization.

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