SlideShare a Scribd company logo
1 of 24
王明鉅
台大醫院 竹東分院院長
1
都是哈佛惹的禍
都是哈佛惹的禍!
2
3
出國
旅遊
4
5
如何降低
醫療成本
如何降低
醫療支出
USA Taiwan
6
錯誤模式 破壞分級
保險變
福利
不節流
腎功能指數
血中肌酸酐
Cr 2.5 mg/dL
定期門診
定期服藥
健康行為
7
保險 福利
8
如果
1年不用健保,保費98折
2年不用健保,保費96折
3年不用健保,保費93折
9
10
全民健保財務問題
12
• 健保藥費1400億
• 進口醫療器材465億
• 自費藥物醫材300億
13
在錯誤的商業模式下
努力Do things right
累壞了大批醫護人員
14
扶老比
15
16
Health care
Medical care
無法
恢復
19
減少醫療支出
減少醫療需求
更健康 抑制
多照護
少看病
減少醫療成
本
Lean ICT
人力
分級
健康不生病
生只生小病
小病不變大
大病不致命
20
健康不生病
生只生小病
小病不變大
大病不致命
21
Do right things
從頭改變
22
不只健保,更要健康
23
解決之道
老人更多
也更健康
強化醫
療服務
能量
擴大照
護體系
24

More Related Content

Viewers also liked

Session 6A - MHS Vision
Session 6A -  MHS VisionSession 6A -  MHS Vision
Session 6A - MHS Vision
MedXellence
 
Healthcare Quality Concepts
Healthcare Quality ConceptsHealthcare Quality Concepts
Healthcare Quality Concepts
alberpaules
 
Quality in healthcare
Quality in healthcare Quality in healthcare
Quality in healthcare
tedpooh
 

Viewers also liked (16)

Session 6A - MHS Vision
Session 6A -  MHS VisionSession 6A -  MHS Vision
Session 6A - MHS Vision
 
20141002-「智慧型『健康管理存摺』創新計畫」報告
20141002-「智慧型『健康管理存摺』創新計畫」報告20141002-「智慧型『健康管理存摺』創新計畫」報告
20141002-「智慧型『健康管理存摺』創新計畫」報告
 
Bookends of the Patient Experience: Improvement Strategies from Admission to ...
Bookends of the Patient Experience: Improvement Strategies from Admission to ...Bookends of the Patient Experience: Improvement Strategies from Admission to ...
Bookends of the Patient Experience: Improvement Strategies from Admission to ...
 
Quality and reliability in health care
Quality and reliability in health careQuality and reliability in health care
Quality and reliability in health care
 
The Formula for Optimizing the Value-Based Healthcare Equation
The Formula for Optimizing the Value-Based Healthcare EquationThe Formula for Optimizing the Value-Based Healthcare Equation
The Formula for Optimizing the Value-Based Healthcare Equation
 
Linking Clinical And Financial Data: The Key To Real Quality And Cost Out
Linking Clinical And Financial Data: The Key To Real Quality And Cost OutLinking Clinical And Financial Data: The Key To Real Quality And Cost Out
Linking Clinical And Financial Data: The Key To Real Quality And Cost Out
 
Healthcare Quality: Basic concepts
Healthcare Quality: Basic concepts Healthcare Quality: Basic concepts
Healthcare Quality: Basic concepts
 
Total quality management in healthcare organisations
Total quality management in healthcare organisationsTotal quality management in healthcare organisations
Total quality management in healthcare organisations
 
Product Quality
Product QualityProduct Quality
Product Quality
 
Improving Patient Safety and Quality Through Culture, Clinical Analytics, Evi...
Improving Patient Safety and Quality Through Culture, Clinical Analytics, Evi...Improving Patient Safety and Quality Through Culture, Clinical Analytics, Evi...
Improving Patient Safety and Quality Through Culture, Clinical Analytics, Evi...
 
Healthcare Quality Concepts
Healthcare Quality ConceptsHealthcare Quality Concepts
Healthcare Quality Concepts
 
Dimensions of Quality in Healthcare
Dimensions of Quality in HealthcareDimensions of Quality in Healthcare
Dimensions of Quality in Healthcare
 
Quality in healthcare
Quality in healthcare Quality in healthcare
Quality in healthcare
 
Quality In Health Care
Quality In Health CareQuality In Health Care
Quality In Health Care
 
Total Quality Management in Healthcare
Total Quality Management in HealthcareTotal Quality Management in Healthcare
Total Quality Management in Healthcare
 
Quality Assurance in Hospitals
Quality Assurance in HospitalsQuality Assurance in Hospitals
Quality Assurance in Hospitals
 

Editor's Notes

  1. 這是人的健康狀態的循環。人一開始總是很健康的,但是隨著年齡與各種生活習慣以及基因的影響,健康也可能亮起黃燈。例如說飯前的血糖100以上,例如血中膽固醇升高,或是因為抽菸造成的肺功能變差。這些都是所謂的亞健康狀態。如果情況再惡化,就可能變成慢性病,或是從亞健康狀態,直接產生了某些急性疾病。然後急性病也許經由手術與治療之後,進入恢復期。也可能沒辦法完全康復而變成慢性疾病。 恢復期之後再好轉成為亞健康,再回到健康狀態。在各個不同的健康狀態中,我們需要不同的健康照護模式。 在「健康」狀態時,我們需要的是健康維持、健康促進與疾病預防。而在亞健康狀態,我們需要的是包括運動、飲食、行為習慣等等的健康管理措施。如果真的變成了慢性病時,例如高血壓、糖尿病時,最適合的照護模式應該是疾病管理、居家照臒與社區醫療照護。雖然急性病是在醫院中用急性疾處理,但是在恢復期的時候,病人需要的還是社區醫療照護與居家照護。而為了回到健康狀態,接下來更要有積極的居家照護,包括了運動復健、飲食等等方式。 因此從這個圖中,我們可以得到幾個重要的結論。 一、健康與亞健康狀態時,健康管理、維持與促進的費用,要遠低於生病後,醫療費用的支出。如果能努力維持大家的健康,讓大家少生病,就有可能減少全民健保支出。因此全民健保應該設計鼓勵民眾維持健康與促進健康的機制。而不是等到民眾生病之後,再來為他負擔醫療費用。 二、不同的健康狀態,最適合的健康照護模式是不同的。因此不應該把所有的醫療照護都由處理急性病人的醫院來處理。這對於許多慢性病疾病管理來說,尤其重要。但是目前的健保制度與醫療模式卻不是這樣子設計的。