頁籤選單縮合
題名 | 全民健康保險成人預防保健服務實施之檢討--1996年之回顧=Review of the Delivery of Pilot Preventive Health Care Services under National Health Insurance in Taiwan--A Preliminary Report in 1996 |
---|---|
作 者 | 李世代; 賴美淑; | 書刊名 | 中華民國家庭醫學雜誌 |
卷期 | 7:2 1997.06[民86.06] |
頁次 | 頁94-105 |
分類號 | 412.56 |
關鍵詞 | 全民健康保險; 成人預防保健服務; Preventive service; Health insurance; |
語文 | 中文(Chinese) |
中文摘要 | 臺灣地區已於1995年3月開辦全民健康保險,並於1996年4月到同年9月,首度在全 民健保給付之下開始實施預防保健服務。四十歲以上成人預防保健服務為其中之重要部份。 本研究旨在嘗試檢討現行成人預防保健服務之實施情形,並為爾後提出因應改進實用之建議 。 半年為期之服務過程中, 量的結構方面共有 642,745 位中老年人參與本項服務; 在 3,013 家健保特約醫療院所中,有 2,036 家加入本項服務行列, 其中以基層醫療院所占絕 大多數。本項服務之總涵蓋率達 12.25 %,已超越先前近期目標之保守估計 8 %。但是, 過程及品質的方面尚難有效掌控,除了本質上保健比較醫療先天之弱勢及國內保健環境仍不 理想外,本項服務仍有諸多要項難以忽略,如前置作業、教育訓練、專科導向、健康效益與 成本效益結構、給付、可近性、品管、業務重疊等多種層面均有值得檢討之處。制度面之未 來展望方面,有三種可能之方案:(一 ) 延續舊制;(二 ) 不擬續辦;(三 ) 併入現行醫療 體系辦理。在面對諸多問題之餘,欲達成整體性之健康目標,尚須針對問題釐定方向;再者 ,必須考量策略、方案、傳佈、監管、評估、提昇、供給、需耗、利用及社經因素,以期獲 得較佳之成效。 |
英文摘要 | In Taiwan, National Health Insurance was started in March, 1995 and the Preventive Health Care Services covered by this polic was started in April, 1996. The one of the Preventive Health Care Services for adults aged over 40 is a main part of it. This study is supposed to review the current status/condition of the delivery of pilot preventive health care service and try to present some practical suggestions for its implementation. From April to September in 1996, a total of 642,745 from middle to old aged and 2,036 of 3,013 clinics contracted with the Insurance program have joined this newly established preventive service. The majority of them belonged to primary practice. With an overall user rate of 12.25%, it has crossed over the conservative pre-set low estimate or goal (8%) already. However, its process and quality are still not effectively under well control. Moreover, there are still some related issues being too important to neglect. In additon to the original vulnerability of preventive care in comparison with therapeutic counterpart, there are more problems needed to be discussed and evaluated, such as insufficient/incompetent preparation, orientation & education/training, specialist-oriented, structure of health-effectiveness & cost-effectiveness, accessibility, reimbursement, quality control & quality assurance, mission overlapping, etc. For the perspective of incoming years, there are three alternative plans ahead, i.e., (a) to continue the current model; (b) to quit & withdraw from this task; (c) to incorporate into existent therapeutic system as a clinical preventive practice. From now on, facing many problems, we must determine how to continue carrying out this important task as it seems necessary and helpful to global health appealing. Besides, we must still concern some domains, such as strategy, tactics, diffusion, monitoring, evaluation, promotion, supply, consumption, utilization, and socioeconomic aspect, to reach better outcomes of this health issue. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。