後SARS台灣重建計畫－SARS事件的社會與經濟衝擊研究─不同醫療體系因應SARS危機動員制度之評估(子計畫五)
Date Issued
2005-02-28
Date
2005-02-28
Author(s)
賴美淑
DOI
922420H002017KC
Abstract
This project aims to understand the responses of various types of hospital to the
2003 SARS outbreak as well as the health authority’s role in this outbreak. Three
primary purposes of this study are: 1) to understand the SARS impact on the use of
healthcare services; 2) to analyze the hospitals’ response and their strategies, and health
authorities’ policies to SARS outbreak; 3) to collect hospital managers’ opinions on the
government’s post –SARS policy: Anti-infections Disease Medical Commanding
System. Hospitals’ claim data analysis, document analysis, and in-depth interview of
key person are conducted in the study.
Comparing the volume of outpatient visits during the same periods in 2002 and 2003,
we observed a 2 % decrease in volume of outpatient visit year-wide and a 14% decrease
during the SARS outbreak period. Among various hospitals of different accreditation
level, the number of outpatient visit to medical centers decreased most significantly
(34%), while public hospitals decreased the most (30%) according to hospital ownership.
As the number of suspected SARS cases and of SARS related news reports increased,
the number of outpatient visit decreased accordingly.
During the SARS outbreak, public, veteran, and military hospitals played a major
role in treating SARS patients. In contrast, most private and non-profit hospitals were
reluctant to admit SARS patient. Governments didn’t evaluate hospitals’ financial loss
due to the admission of SARS patient, although they were guarantees concerning
financial supports. As to governments’ anti-SARS policy, the chain of command was not
established at first. They didn’t effectively allocate relevant medical resource, including
manpower, quarantine wards, and protective materials (N95 masks, and quarantine
clothing).
Regarding to the Anti-infections Disease Medical Commanding System, most of
interviewees agreed that public and military hospitals will play important roles in
anti-communicable disease similar to SARS. The also agreed that medical centers are
not appropriate to be designated as infectious disease hospitals. However, they can
provide specialties and expertise in fighting the disease. They are also worried about the
ability of SARS hospitals designated by the government, because most of those hospitals
are of smaller scales. Comparing the anti-SARS experience in Singapore, Hong Kong,
and Canada, we observed similar situation as Taiwan in the early-SARS period, due to
the lack of information on SARS, governments were unable to develop good strategies.
Singapore’s single health authority directed by ministry of defense tends to be the
efficient one among the 4 countries. This system makes Singapore quick responses to
SARS outbreak without conflict among organizations. Each county all designate one or
several SARS hospitals to treat SARS suspect and all these hospitals are government
owned or public funded.
Final, we suggest that our government should develop a single chain of command
for such disease, reassess the compensation system for hospitals, enforce hospital
infection control, and implement practices periodically the Anti-infections Disease
Medical Commanding System.
SDGs
Publisher
臺北市：國立臺灣大學公共衛生學院預防醫學研究所
Type
report
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