AmCham Taiwan Healthy Aging Forum:
2025健康台灣樂齡論壇:公私協力促進全人健康
AmCham Taiwan Healthy Aging Forum:
2025健康台灣樂齡論壇:公私協力促進全人健康
Committee Events & Luncheons
Since the pandemic, the critical role of public health efforts in preventing diseases, promoting better health practices, and building resilient healthcare systems has become more evident than ever. Public health initiatives must rapidly address crises and enhance healthcare efficiency through informed policymaking, community health education, and disease prevention and control. The Committee remains steadfast in its commitment to advocate for policies and practices that achieve these essential goals.
The Committee extends its gratitude to the Ministry of Health and Welfare (MOHW) for responding to our previous White Paper recommendations by actively planning a national chronic disease prevention and control program, amending the Rules of Medical Diagnosis and Treatment by Telecommunications to expand the availability of telemedicine, and supporting the development of digital healthcare. The focus of the Taiwan Centers for Disease Control (CDC) on disease prevention, particularly through the expanded pneumococcal vaccination program for individuals aged 65 and over, is also commendable.
We strongly call on the government to designate a central entity under the MOHW to take charge of the nation’s public health priorities, particularly considering emerging challenges related to low birth rates and a super-aged population. Moreover, the government should proactively take comprehensive measures to reinforce disease prevention and health promotion among all citizens, thereby reducing unnecessary medical expenditures and enhancing the nation’s economic productivity. Based on these considerations, the Committee presents the following suggestions:
Suggestion 1: Optimize chronic disease management and prevention with a patient-centered care model to improve health outcomes.
Taiwan is set to become a super-aged society next year, with at least 20% of the population aged 65 and above. This demographic shift, exacerbated by factors such as climate change, has naturally increased the prevalence of chronic diseases. According to the 2017 National Health Interview Survey, nearly 85% of the elderly population suffered from at least one chronic disease. Furthermore, the MOHW’s 2023 Taiwan Health and Welfare Report states that approximately 60% of individuals aged 65 and above are afflicted with two or more chronic diseases.
In anticipation of the MOHW’s continued development of a national chronic disease prevention and control plan, the Committee urges swift government action to enhance overall disease prevention and control effectiveness through cross-ministerial cooperation covering areas such as health education and labor policies supporting health. To address the complexity of chronic disease management, we recommend that the government take the following measures:
1.1 Set specific control goals referencing international indicators. These goals should include managing primary factors such as blood pressure, blood sugar, blood lipids, smoking, and obesity to prevent or delay the occurrence of chronic diseases. The government should refer to established plans like the U.S. Healthy People 2030 initiative, the UK NHS Long Term Plan, and Health Japan 21 for goal-setting inspiration. For instance, the United States has set a goal of ensuring that 55% of patients diagnosed with hyperlipidemia receive treatment by 2030. To avoid comorbidity risks, the U.S. government has set an additional target for 2030 to reduce the proportion of adults with undiagnosed prediabetes to 33.2% as a high-risk group for type 2 diabetes, heart disease, and stroke.
Similarly, the United Kingdom has established a target to complete cardiovascular risk assessments for 75% of the population aged over 40 by 2029, with a corresponding increase in blood lipid treatment rates for individuals with a history of cardiovascular disease. The NHS Long Term Plan will also strengthen diabetes prevention through obesity reduction efforts.
1.2 Establish a patient-centered care model with enhanced tracking and follow-up management. We encourage the government to continue collaborating across sectors to promote screening and risk assessment, targeting specific high-risk groups. For example, to mitigate risks of health disease complications, heart disease screening rates for those over 65 should be increased and heart failure-case management programs expanded. The coverage rate under the Diabetes Shared Care Network should also be enhanced to over 60% with the total number of diabetes patients as a base.
In addition to screenings and risk assessment, we call on the government to optimize resource allocation by integrating health information across such data sources as adult health check-ups, health examinations, and National Health Insurance (NHI) databases, in addition to developing case management plans aligned with international treatment guidelines. Digital tools and reimbursement incentives should be utilized to support healthcare professionals in patient-centric tracking and case management, enhancing the effectiveness and efficiency of healthcare services. Moreover, public education, prevention awareness campaigns, and promotion of self-health management knowledge should be prioritized to encourage shared decision-making practices and holistic care, especially amid industry labor shortages.
Suggestion 2: Strengthen early disease detection and refine vaccination strategies for the elderly.
NHI statistics show that senior citizens account for 40.6% of the total medical expenditures in Taiwan, underscoring the critical need for efficacious disease prevention and intervention strategies. Given the rising life expectancy in Taiwan, it is imperative to prioritize the reduction of morbidity in later life stages to ensure the sustainability of the healthcare system.
2.1 Implement legislation for dementia prevention and care. Dementia poses a significant health risk to the elderly population, with statistics showing that the condition affects 1 in every 13 individuals in Taiwan over the age of 65. We suggest that the government look to examples such as Japan’s Dementia Basic Act and South Korea’s Dementia Management Act to establish an act for dementia management. The proposed act should similarly seek to clearly define the government’s responsibilities in supporting those with dementia and ensure that policies are regularly updated.
The establishment of a dedicated dementia policy promotion team within the Executive Yuan would facilitate comprehensive and integrated policy planning across various ministries and commissions, focusing on the prevention, diagnosis, treatment, and care of dementia.
The Committee acknowledges the MOHW’s efforts in formulating the Dementia Prevention and Care Policy and Action Plan 2.0 to establish a national dementia registration and monitoring system, encompassing the Dementia Care Service Management System and the Dementia Care Policy Control System. We look forward to the full implementation of this national dementia patient registry interface, which will aid the management of disease trends and allow for more timely policy adjustments.
In addition, the Committee calls on the government to actively strengthen early screening for dementia, including implementing screening programs, raising public awareness, and training medical professionals to identify early signs of cognitive decline and dementia, such as using cognitive testing and brain imaging. Taiwan should advance innovative diagnostic tools and interventions to improve outcomes for early-stage dementia, incorporating precision medicine approaches in diagnosing early Alzheimer’s disease by utilizing biomarkers to identify individuals at high risk and tailor treatment plans accordingly.
2.2 Streamline the preventive vaccination process for the elderly and increase annual completion rates. Leveraging the success of its childhood vaccination programs, the government should set and rigorously track annual improvement targets for vaccination rates for the elderly. We urge the CDC to reassess and simplify the multiple vaccination programs for seniors, ensuring that information is easily accessible and understandable to encourage participation.
In recent years, influenza vaccination rates among the elderly have remained at around 50%, significantly lower than in advanced countries such as Australia, South Korea, and the United States, where inoculation rates reach between 70% and 80%. Moreover, the Covid-19 XBB vaccine uptake in Taiwan was below 20% in 2023. Meanwhile, countries like South Korea and Japan have implemented robust policies for the co-administration of influenza and Covid-19 vaccines, achieving over 40% coverage. Taiwan must enhance vaccination rates among the elderly to reduce infection rates, disease severity, and preventable mortality rates.
Given the mobility challenges faced by many elderly, we recommend that the CDC encourage local health authorities to adhere to World Health Organization (WHO) influenza vaccine recommendations and promote co-administration of influenza and Covid-19 vaccines. The CDC should also promptly establish walk-in vaccination sites, aimed at enhancing accessibility and increasing vaccination rates.
Suggestion 3: Enhance cancer management through proactive strategies and become a leading force for cancer treatment in Asia.
Since the inception of Taiwan’s National Cancer Control Program in 2005, substantial advancements have been achieved in the realms of prevention, screening, diagnosis, and palliative care. Despite these efforts, there remains room for improvement in Taiwan’s cancer statistics.
In 2021, Taiwan reported a cancer diagnosis every four minutes. This standardized incidence rate of 306.5 per 100,000 individuals marked the first decline in nearly a decade. Nevertheless, the cancer incidence rate in Taiwan for 2022 was higher than that of Japan (267.1), South Korea (234.7), and Singapore (231.1). Although the standardized death rate due to cancer in Taiwan has shown a steady decline, the latest statistics from the MOHW in 2022 indicate a mortality rate of 116 per 100,000 people, exceeding that of Japan (78.6), South Korea (77), and Singapore (110.8).
3.1 Accelerate the allocation of the Cancer Drugs Fund and establish a national-level cancer office for effective prevention and control. While Taiwan’s national cancer prevention and control program emphasizes early prevention, the program lacks a comprehensive medical strategy, resulting in lower-than-expected effectiveness in decreasing cancer mortality rates. Lung cancer (the cancer with the highest global mortality rate) became Taiwan’s “triple champion” in terms of high mortality rate, incidence rate, and proportion of late-stage diagnosis in 2023. This development comes notwithstanding Taiwan’s status as the first country to provide low-dose computed tomography (LDCT) lung cancer screening for heavy smokers and individuals with a family history of lung cancer.
Liver cancer, the second leading cause of cancer mortality, is notably linked to hepatitis B in approximately 70% of cases. To mitigate the incidence of liver cancer effectively, it is imperative to ensure that hepatitis B treatment protocols conform with international standards.
The Committee urges the government to swiftly implement the proposed NT$10 billion cancer drugs fund, enabling the introduction of innovative drugs in alignment with international standards to improve the outcomes for these patients. Moreover, we recommend that the government establish a dedicated office addressing high-incidence and high-mortality cancer types and consolidating resources across ministries and agencies.
3.2 Strengthen prevention by aligning vaccine and screening policies with international standards and enhancing the three-step, five-level public health strategy. In Taiwan, cervical cancer screening has relied on conventional Pap smears since 1995. To improve accuracy and efficiency, the Committee recommends incorporating human papillomavirus (HPV) testing and cytology (cell tissue examination from Pap smears or liquid-based cytology) in routine screening.
While efforts to control tobacco, alcohol, and betel nut usage have stabilized oral pharyngeal cancer rates, the incidence of HPV-related oral pharyngeal cancer has increased. The Committee recommends that Taiwan align itself with the nearly 60 WHO-member countries that include HPV vaccinations in routine publicly funded vaccination programs for both sexes.
Cases of breast cancer, which has the highest incidence rate among women, have doubled in the past 20 years. While Taiwan offers screening for women between the ages of 45 and 69, only 50% of eligible women undergo yearly screening. To increase screening rates and aid early detection, the government should consider adopting 3D mammography, which is more advanced, comfortable, and widely accepted than traditional mammography. This type of mammography is also recommended by the American Cancer Society.
3.3 Utilize quantifiable indicators for cancer control and regular reviews to close the cancer incidence and mortality rate gap between Taiwan and neighboring countries. To enhance cancer prevention and control, the government should implement definitive strategies and actions that directly address the substantial disparities in cancer incidence and mortality rates in comparison to Japan and South Korea. Regular monitoring, follow-up, and the provision of comprehensive improvement reports by government are crucial to expedite progress in achieving the vision of a healthy Taiwan.
Suggestion 4: Work collaboratively with domestic and global health industry partners to facilitate digital transformation, setting the paradigm for Asia.
Digital healthcare and healthcare transformation can help effectively address the uncertainty of novel infectious diseases, the impact of a rapidly aging population, and the challenges of managing chronic disease. The Committee appreciates the National Health Insurance Administration’s plan to empower patients and medical staff by removing healthcare limitations through its patient-centered digital program for medical equality. Building a digital healthcare network requires closer partnership with the healthcare industry, resource integration led by the MOHW, and incentives that encourage the utilization of digital health by society and care providers. To achieve the public interest objectives outlined in the proposed regulations governing health and welfare data management, we recommend that the government incorporate provisions into regulations that permit the private sector to request access to comprehensive, real-time health data. This approach would facilitate more effective data utilization in health and welfare initiatives, aligning with the overarching goals of the regulations.
4.1 Designate a dedicated agency under the MOHW to promote the application and development of digital health technology. The Committee recommends establishing a dedicated agency that plans digital medical policies, including budget and resource allocation, and harmonizes regulations related to digital health development. The agency should also assist with coordination and communication with relevant ministries under the Executive Yuan and establish a platform for further exchanges and cooperation among government, industry, and academia to ensure effective information disclosure and communication. The effective operation of such an agency would encourage domestic and international industry partners to participate in accelerating the development and implementation of digital health in Taiwan.
4.2 Concretize the digital health sandbox project by providing specific implementation timelines and other details. The Committee welcomes the government’s plan to establish a digital health sandbox, supported by multiple agency budgets, for testing potential digital health solutions. To ensure the sustainability of the digital healthcare industry, we suggest that the MOHW release a specific implementation timeline and other relevant details while stakeholders are informed of progress.
Suggestion 5: Adopt life-course immunization into national policies, enhance vaccine education and communication, and establish robust infection and antimicrobial resistance (AMR) pricing mechanisms.
Vaccine hesitancy and AMR have been identified by the WHO as 2 of the 10 most pressing threats to global health. Taiwan’s successful management of the Covid-19 pandemic should be sustained and extended to the management of AMR and all vaccine-preventable diseases. Gaps in funding, public awareness, and access must be bridged to fully realize the benefits of life-course immunization. We encourage the government to take bolder steps and make critical investments in cost-effective measures for future pandemic preparedness.
5.1 Integrate life-course immunization strategies. Immunization programs integrated into the broader health system can comprehensively address evolving health needs, optimize resource utilization, and improve health outcomes. We recommend that the MOHW and the CDC systematically review and update policies to promote life-course immunization. Efforts should include ensuring adequate budget allocation, integrating adult vaccination records, and implementing public education initiatives. Furthermore, we encourage the health authorities to adopt international best practices to fully maximize preventative benefits and ensure readiness for future pandemics.
5.2 Enhance communication channels for vaccine education. To elevate public awareness of vaccination effectiveness and combat vaccine hesitancy resulting from misinformation, it is crucial to enhance communication channels among government, industry, and the public.
We commend the CDC for its effective Covid-19 vaccination communication efforts and urge it to expand these actions to other vaccines while transparently disclosing vaccine information, including details on vaccine brands, manufacturers, and eligibility criteria. We also recommend that the CDC establish a dedicated webpage for vaccine information, mirroring practices in leading countries that facilitate access to accurate information. Additionally, we stress the importance of collaborating with educational departments to incorporate vaccine education into school curricula, strengthening students’ understanding of this critical public health measure.
Regular biannual exchanges between the authorities and industry on national immunization and vaccine education issues will further enhance comprehensive vaccine education programs. This collaboration will help Taiwan reach public health goals related to disease prevention through vaccination.
5.3 Encourage infection control and build a special pricing mechanism for antibiotics. Effective infection control requires sustained and continuous national investment. We appreciate the government’s allocation of NT$225 million in the 2024 NHI budget for the anti-infectives management and infection control quality enhancement plan, reflecting its recognition of clinical efforts in infection control.
To combat the threat of AMR, it is imperative that hospitals and physicians continue to provide clear incentives for infection control beyond one-year plans. Moreover, considering the low margins for antibiotics, the Committee calls for the government to offer price premiums for these drugs. If the clinical efficacy of new antibiotics demonstrates moderate or significant improvement, the price setting should be above the median price of A10 countries. In addition, the Committee urges the government to establish an independent pricing-adjustment mechanism for existing products to sustain antibiotic diversity. This measure would prevent the withdrawal of antibiotics from the market and help mitigate the threat of AMR.
自疫情以來,公共衛生於預防疾病、推廣促進健康之措施、以及建立具韌性的醫療體系等方面,其關鍵作用已比以往任何時候都更為明顯。公共衛生的政策必須迅速處理危機,並透過詳盡的政策制定、社區衛生教育以及疾病的預防與控制來提升醫療效率。委員會將持續致力於倡議使上述重要目標政策得以實踐。
本委員感謝衛生福利部回應我們之前的白皮書建議,積極規劃國家慢性病的預防與控制計畫、修訂《 通訊診察治療辦法》,及擴大遠距醫療適用場域以助於數位醫療的發展。而台灣疾病管制署對疾病預防的重視,特別是擴大肺炎鏈球菌的疫苗接種範圍至65歲以上族群亦值得讚許。
面對低生育率和超高齡人口相關的挑戰,我們強烈呼籲政府在衛生福利部之下建立專責單位,以負責國家公共衛生要務。此外,政府應積極採取全面措施加強疾病預防和促進公民健康,從而減少不必要的醫療開支,提升國家經濟生產力。基於這些考量,本委員會提出以下建議:
建議一:「以病人為中心」改善慢性病管理與防治以提升整體成效
台灣預計將於明年邁入超高齡社會,屆時65歲以上人口約佔總數20%,慢性疾病的盛行率將隨人口結構的改變以及氣候變遷等因素加劇推升。2017年國民健康訪問調查顯示,將近85% 的高齡人口至少罹患一項慢性病,而根據衛生福利部2023年「衛生福利年報」,約有60%的65歲以上民眾患有兩種以上之慢性病。故本委員會對衛生福利部規劃中的「國家慢性疾病防治計畫」相當期待,希望政府能加快腳步,透過跨部會合作納入如健康教育及勞工健康政策等領域,以提升整體疾病防治效益。有鑑於慢性疾病防治管理之複雜性,委員會建議政府採納以下措施:
1.1 參考國際指標設立具體疾病防治目標
慢性疾病防治首重風險因子(如血壓、血糖、血脂、吸菸、肥胖)的管理,以進一步預防或延緩疾病的發生。我們建議政府參考國際作法設立針對風險因子的管理目標,例如美國Healthy People 2030、英國NHS Long Term Plan、及日本Health Japan 21。舉例來說,美國之目標為高血脂病人確實獲得治療的比例在2030年達到55%,另為降低共病風險,也設定達到2030年降低未知自己罹患糖尿病前期的成年人比例至33.2%的目標。
英國的目標則是在2029年之前為75%四十歲以上的民眾完成至少一次心血管風險評估,並使具有此疾病史患者之治療率相對應地增加,在NHS計畫中也透過降低肥胖的方式加強糖尿病預防。
1.2 建立以病人為中心的照護機制並確實追蹤管理
我們鼓勵政府持續與各界合作推廣篩檢和風險評估,並針對特定高危險群採取加強措施,例如針對65歲以上罹患心臟疾病風險較高的民眾,應加強心臟病篩檢率,且持續擴大心臟衰竭個案管理計畫的覆蓋率與追蹤;針對糖尿病管理達成糖尿病共照網覆蓋率達60%(以糖尿病患者總數為基數)。此外,除了疾病篩檢和風險評估,我們呼籲政府最適化資源配置,建立以病人為中心的追蹤與個案管理架構。此架構應串連整合跨部會的健康資料(例如成人健檢、勞工健檢、健保資料庫等),並參考國際治療指引之標準設計個案管理計畫,善用數位工具和給付獎勵誘因,以提升醫療服務之效能與效率,更透過民眾衛教、疾病預防覺察推廣,與促進自我健康管理識能等方向,在落實醫病共享決策與全人整合照護的同時,亦可因應未來醫療人力日益緊縮的挑戰。
建議二: 強化早期疾病檢測並優化高齡族群疫苗接種策略
根據全民健康保險統計,高齡長者的醫療支出已占全國總醫療支出的40.6%,凸顯出有效的疾病預防與介入策略的迫切需求。隨著國人平均壽命的延長,應優先降低老年疾病的發生率,以確保醫療照護體系的永續發展。
2.1 設立「失智症防治照護專法」
失智症對高齡族群構成重大的健康風險,根據統計,台灣65歲以上的長者中,每13人就有一位患有失智症,委員會建議台灣政府效法日、韓設立「失智症防治照護專法」,明確政府權責,定期檢視並更新國家政策;並由行政院設立「失智症政策推動小組」,推動完善且跨部會的整合政策,加強各部會在防治、診療、照護整合的協作力度。
委員會認同衛生福利部對於執行「失智症防治照護政策綱領暨行動方案2.0」上的努力,包含失智照護服務管理系統和失智照護政策管考系統,同時也期待全國失智症登錄系統的全面實行,將有助於疾病趨勢管理並即時調整對應政策。
此外,委員會也呼籲政府應積極加強失智症的早期篩檢,推行篩檢計劃和提高公眾疾病意識,並培訓醫療專業人員運用認知測試和腦部影像判讀等專業能力,辨識認知能力下降等失智症的早期跡象。同時,台灣也應提升早期失智症的創新診斷工具和介入措施,以改善早期失智症的症狀,例如:將精準醫學方法納入阿茲海默症的早期診斷,利用生物標記物來識別高風險個體並銜接合適的治療計劃。
2.2 簡化老年人預防性疫苗接種措施,提升年度接種完成率
借鑑兒童疫苗接種計劃的成功落實,政府應設定並嚴格追蹤高齡長者疫苗接種完成率的每年度之改進目標。我們敦促疾病管制署重新評估並簡化針對老年人的多項疫苗接種計劃,確保資訊容易獲取並易於理解,以鼓勵長者參與。
近年來,台灣高齡長者的流感疫苗接種率一直維持在約五成,明顯低於澳洲、南韓和美國等先進國家70-80%的接種率。儘管已將肺炎鏈球菌疫苗擴展至65歲以上公民,但自2023年以來,新冠XBB疫苗的接種率仍未超過20%;相比韓國和日本政府強力落實流感與新冠疫苗同時接種的策略,使其接種覆蓋率超過四成之多。台灣亟需提升高齡長者的疫苗接種完成率,以降低疾病嚴重性及可預防的感染和死亡風險。
有鑑於許多長者行動力上的限制,我們建議疾病管制署應鼓勵地方衛生機關遵循世界衛生組織(WHO)對流感疫苗的建議,推廣同時接種流感與新冠疫苗,並應立即設立疫苗接種站,以提升接種便利性並增加接種率。
建議三:透過積極策略強化癌症防治,成為亞洲癌症防治之先驅
自2005年國家癌症防治計畫實施以來,在癌症預防、篩檢、診斷和緩和醫療等領域已取得顯著進展;但除了這些成就,台灣的癌症統計數據仍有努力的空間。2021年,台灣平均每4分鐘會有一人罹癌,全癌症標準化發生率為每10萬人口306.5人,是近十年來首次下降;然而2022年台灣的癌症發生率仍高於日本(267.1)、韓國(234.7)和新加坡(231.1)。且雖然台灣的癌症標準化死亡率呈現穩定下降的趨勢,但根據衛福部2022年的最新統計數據顯示,癌症的死亡率為每10萬人116人,高於鄰近國家如日本(78.6)、韓國(77)和新加坡(110.8)。
3.1 加速百億癌症新藥基金的導入,並建立國家級癌症辦公室以有效落實癌症防治。
雖然國家癌症防治計畫著重於早期預防,但計畫缺乏整體醫療策略,以至於無法如預期地有效降低癌症死亡率。以全球死亡率最高的癌別—肺癌為例,儘管台灣領先全球,是第一個為具有肺癌家族史及重度吸菸者提供電腦斷層(LDCT)肺癌篩檢的國家,但肺癌在台灣仍於2023年高居死亡率、發生率及晚期確診比例之首。
另外肝癌高居死亡率第二,其中70% 肝癌是B型肝炎所導致,為有效預防肝癌的發生,必須確保B肝的治療符合國際標準。
委員會建議政府盡速實現其提出之百億癌症新藥基金計畫,引進創新藥物使我國癌症防治可與國際接軌,以期實質改善癌症病患治療成效;並建立專責辦公室,處理高發生率及高死亡率之癌別,亦能統整跨部會及機構之資源。
3.2 將疫苗和篩檢政策與國際標準接軌,精進三段五級公衛策略,以強化疾病預防 。
台灣自1995年起推動子宫頸癌篩檢後,目前仍採傳統的巴氏抹片檢查;為提升篩檢的精準度和效率,委員會建議將HPV檢測和抹片檢查(傳統抹片或液基抹片)合併納入常規篩檢。
而在菸酒檳榔防治努力下,頭頸口咽癌的發生率越趨平緩,但由HPV感染的口咽癌發生率卻有所增加;故委員會建議台灣跟進WHO近60個國家,將兩性皆施打HPV疫苗納入常規公費疫苗。
至於婦女癌症發生率之首的乳癌,發生率於過去20年間增加了兩倍;儘管台灣為45至69歲的女性提供篩檢服務,但每年僅有一半的女性符合條件而接受篩檢。為了提高篩檢率及促進早期診斷,政府應參考美國癌症醫學會建議,導入先進、較為舒適且接受度高的3D乳房攝影。
3.3 量化癌症防治指標並定期檢討,以缩小台灣與日韓之癌症發生率及死亡率的差距
為了強化台灣的癌症防治工作,政府應採取明確的策略及行動以解決台灣與日本和韓國之癌症發生率及死亡率的顯著差距。政府須定期監測、追蹤及提出完善的改進檢討報告,以加強執行力道、加速實現健康台灣的願景。
建議四:攜手國內外產業夥伴,加速推動醫療數位轉型,成為亞洲典範
面對新興傳染病的不確定性、快速高齡化社會對醫療照護體系的衝擊、以及慢性病對疾病管理的挑戰,透過數位醫療與照護轉型來提高照護效率是一個刻不容緩課題。委員會對健保署計畫提高民眾健康賦能、醫事人員賦權、打破圍牆的醫療照護等以病人為中心的醫療平權數位升級計畫予以高度肯定。打造數位醫療照護網需要更多的醫療產業公私協力並由衛福部領導整合資源,同時透過鼓勵機制提高民眾和醫療提供者應用數位醫療。為實現《衛生福利資料管理條例》草案之公益目的,我們建議政府納入私部門亦得申請使用即時且非片斷之衛生福利資料,在與法規的總體目標一致下促進數據的有效利用。
4.1 於衛生福利部下設專責窗口,推動數位醫療技術應用與發展
委員會建議設立專責窗口規劃數位醫療政策、綜理協調衛福部所屬各單位有關數位醫療發展之法規與事務,並協助衛福部內跨單位的預算與資源整合。此專責單位也應負責與行政院相關部會間的協調與溝通、建立產官學交流與合作平台,確保各項資訊公開與溝通順暢,並鼓勵國內外產業共同參與及合作,加速數位醫療發展與落地。
4.2 針對數位醫療健保沙盒試辦計畫,提供具體推動時程與執行內容
委員會樂見政府針對數位醫療推動健保沙盒試辦計畫,並由跨部會科技計畫經費支應,我們建議主管機關應具體公布健保沙盒推動時程與執行內容,積極與各界溝通,以利數位醫療照護產業永續發展。
建議五:將全年齡預防接種納入國家政策、加強疫苗教育和溝通,並建立健全的感染控制與抗生素抗藥性(AMR)定價機制。
疫苗猶豫和抗生素抗藥性已被世界衛生組織(WHO)列為全球十大迫切威脅健康的關鍵因素,台灣在控制新冠疫情的成功應持續擴展到所有疫苗可預防之疾病,以及抗生素抗藥性(AMR)的管理。我們建議政府應消除預算缺口、提升民眾認知及提高獲取相關資訊的便捷性,才能充分實現全年齡疫苗接種的益處。我們鼓勵政府採取更大膽的措施,並在具有成本效益的措施上進行關鍵投資,以在未來大規模疫情發生前能有充分準備。
5.1 整合推動全年齡疫苗接種策略
將全齡疫苗接種計畫整合至更廣泛的醫療體系及決策系統,能因應持續增加的醫療需求、有效利用資源,並增進醫療成效。我們建議衛生福利部及疾病管制署系統性地檢視並調整疫苗政策,以推動全年齡疫苗接種。未來可持續努力的方向包含:分配充足的預算、整合成人疫苗接種紀錄、公眾教育計畫等。此外,我們也鼓勵健康醫療主管機關參考國際實踐案例,最大化疾病預防效益,並確保在下一次大規模疫情前做好充足準備。
5.2 強化疫苗教育溝通管道
為提升公眾對疫苗有效性的認知,並打擊因錯誤資訊造成的疫苗猶豫,增進政府、產業和大眾間的溝通管道可謂至關重要。
我們肯定疾病管制署在宣導Covid-19 疫苗方面的努力,也盼相同的疫苗教育推展至其他類別疫苗,同時透明揭露疫苗相關訊息,包括疫苗廠牌、製造商和接種條件等詳細內容。我們建議疾管署借鏡其他先進國家的做法,建置疫苗訊息專屬網頁,以利公眾能夠獲得正確的訊息。此外我們也強調與教育單位合作的重要性,將疫苗教育納入學校課程,以加強學生對此重要公共衛生措施的理解。
而衛生主管機關若能與產業界每半年定期針對國家免疫和疫苗教育進行交流,將能進一步完善疫苗教育計劃,這樣的交流合作將有助於台灣達成與疫苗接種相關之疾病預防公衛目標。
5.3 鼓勵感染管制,並建立抗生素獨立藥價調整機制
有效的感染管制需要國家的持續投資。委員會感謝政府於2024年健保總額開始編列2.25億「抗微生物製劑管理及感染管制品質提升計畫」專款,反映出政府對於感染管制於臨床上的認可與努力。
為應對抗生素抗藥性的威脅,須持續提供醫院及醫師執行感染管制的明確獎勵,不能單為一年計畫。此外,考量抗生素類藥物利潤偏低,委員會呼籲政府應給予抗生素價格加成;若新抗生素於臨床療效達中等或顯著改善,健保核價應高於十大醫藥先進國中位價。同時,委員會敦促政府建立既有抗生素的獨立價格調整機制,以維持抗生素藥品多元性,除能避免抗生素藥品退出市場,也能降低抗生素抗藥性威脅。