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\"score\": 0.875}, {\"word\": \"還\"}, {\"word\": \"是\", \"start\": 806.664, \"end\": 806.785, \"score\": 0.828}, {\"word\": \"要\", \"start\": 806.785, \"end\": 806.925, \"score\": 0.971}, {\"word\": \"跟\", \"start\": 806.925, \"end\": 807.085, \"score\": 0.922}, {\"word\": \"主\", \"start\": 807.085, \"end\": 807.226, \"score\": 0.996}, {\"word\": \"席\", \"start\": 807.226, \"end\": 807.406, \"score\": 0.993}, {\"word\": \"抗\", \"start\": 807.406, \"end\": 807.687, \"score\": 0.992}, {\"word\": \"議\"}, {\"word\": \"一\", \"start\": 807.687, \"end\": 807.967, \"score\": 0.976}, {\"word\": \"下\", \"start\": 807.967, \"end\": 808.569, \"score\": 0.957}, {\"word\": \"因\", \"start\": 808.569, \"end\": 808.769, \"score\": 0.9}, {\"word\": \"為\"}, {\"word\": \"前\", \"start\": 808.769, \"end\": 808.889, \"score\": 0.839}, {\"word\": \"面\", \"start\": 808.889, \"end\": 809.13, \"score\": 0.991}, {\"word\": \"是\", \"start\": 809.13, \"end\": 809.29, \"score\": 0.876}, {\"word\": \"可\", \"start\": 809.29, \"end\": 809.37, \"score\": 0.739}, {\"word\": \"以\", \"start\": 809.37, \"end\": 809.43, \"score\": 0.685}, {\"word\": \"講\"}, {\"word\": \"到\", \"start\": 809.43, \"end\": 810.052, \"score\": 0.872}, {\"word\": \"2\"}, {\"word\": \"0\"}, {\"word\": \"分\", \"start\": 810.052, \"end\": 810.874, \"score\": 0.953}, {\"word\": \"鐘\"}, {\"word\": \"以\", \"start\": 810.874, \"end\": 810.974, \"score\": 0.797}, {\"word\": \"上\", \"start\": 810.974, \"end\": 810.994, \"score\": 0.554}, {\"word\": \"謝\"}, {\"word\": \"謝\"}], \"language\": \"zh\"}","srt":"1\n00:00:04,720 --> 00:00:06,783\n麻煩邱部長邱部長請委員長\n\n2\n00:00:16,597 --> 00:00:41,474\n今年2月22號我們臺灣急診醫學會就發出我們的政策聲明表示我們的急診用篩已達到前所未有的嚴重程度如果這問題持續的話大概會引發到我們的醫護人員大規模的離職甚至會進一步削弱我們醫療體系的承受能力所以急診室用篩有原因事實上是\n\n3\n00:00:43,293 --> 00:01:03,271\n醫療擁塞跟我們的病床擁塞不過這次事件大概是春節期間大概七天很多門診事實上是休診的所以導致了我們的延伸到的醫療擁塞可是隨著假期結束之後照理來講應該是緩解了可是到2月22號還不能紓解的應該事實上是病床擁塞\n\n4\n00:01:06,033 --> 00:01:33,114\n一直以來我們看到是過去本來就是這個就存在的一種現象也就是醫護人員招不滿的話就導致病床開不出來所以呢民眾平日的預約住院就要排隊個三五天那這一次的我們的普通病床跟ICU一路回堵到急診室問題才會這麼嚴重所以想問部長事件持續這麼長的時間那外界呢對衛福部處理的\n\n5\n00:01:34,391 --> 00:01:37,099\n動作覺得太緩慢你作何解釋其實\n\n6\n00:01:41,595 --> 00:02:10,556\n我們都有預防性的處理,譬如說在春節前其實不只公部門,我們也都有醫師公會已經連續七八年了,都在急診前都要譬如說要大家打預防針,要大家就診的一個怎麼樣分流然後我們在不管是健保署或疾管署都有提供經費給急診去開譬如說專人病房一個門診另外一個人力然後也鼓勵我們的急診診所能夠在\n\n7\n00:02:11,434 --> 00:02:36,110\n假日的時候能夠多開診而且都給他多一點譬如說三成的一個補助這個就是比較有預防性的然後也當時政府也多買了10萬劑的流感疫苗讓大家能夠希望避免得到相關的傳染病我想預防的措施是非常重要的那長期來講怎麼樣我們國家本來就一直在做分級分流\n\n8\n00:02:37,590 --> 00:02:58,694\n區域聯防的體系這個一直在做面對急診的困境到年後還是這樣子的時候當然我們就必須要更積極所以從大概3月2號開始連續我們到現在也有至少5次的會議出席的人是包括各衛生局各醫院院長幾乎幾百個用線上的在討論怎麼來解決這個問題\n\n9\n00:03:03,255 --> 00:03:25,751\n那當然也包括急診醫學會,所以我們提出了三個緊急趕快處理的,持續再做兩個中長程的第一個你院內趕快調度,拜託院方能夠看看譬如說門診住院的話,哪一檔看完就看完,回去進行梳理我們有一個理念,急診你說到底要待多久?\n\n10\n00:03:26,511 --> 00:03:40,997\n居德病能夠越快住院越好啊這是最重要的理念你剛剛提你們開了很多會可是2月3號年假就結束了可是衛福部到2月8號才邀集我們的疾管署和22個縣市衛生局跟14個轉診的網絡醫院主持人\n\n11\n00:03:44,943 --> 00:04:09,682\n跟六區的緊急醫療應變中心執行長來召開會議討論那這個時間點我們當然看到衛福部自己講說急診量從4.5萬人次就是降為2.1萬人次可是等待住院的人還是偏高所以2月22號我們的急診醫學會才會出來發表聲明那衛福部自己也承認說病床擁塞的問題還是很嚴重所以想問\n\n12\n00:04:12,245 --> 00:04:22,538\n今天春節期間在急診室最擁塞的時候民眾等待床位超過一天是常態那急診擁塞事件當下衛福部有掌握嗎\n\n13\n00:04:23,812 --> 00:04:51,239\n就在春節期間我們每一天都每15分鐘那衛福部做了什麼樣的應變措施當然一定是努力去應變那你的應變措施到底是什麼應變措施我剛剛跟委員報告第一個就是說希望讓急診的後床的人能夠減少第二個希望當然還有等候看診其實等候看診的人都不是那麼長我們每天可以去追溯data大概\n\n14\n00:04:52,259 --> 00:05:20,917\n委員所講的超過1000個就是51家的一個醫院我們說統計51家大概如果平均有20個後床的大概就會超過1000個那基本上還是在那幾家啦我們第一名的永遠都是林和長庚台大、高一、高雄長庚其實看起來都比較常例前茅啦那這個部分我們當然希望這些醫院能夠去\n\n15\n00:05:22,078 --> 00:05:46,551\n積極的去處理嘛那剛剛講的三個緊急的處理第一個就是說院內去調配這個部分有些醫院做得還不錯當然有些婦女人覺得說會承受更多的壓力這個部分我們也了解但是就是院方一定要去好好的溝通平常也要訓練好第二個我們當然區域聯訪很重要所以我們這個時候部醫院26家醫院也跟五個訓練也站出來\n\n16\n00:05:47,331 --> 00:06:09,714\n呈上啟下不管是上面的那這個部分也吸收了不少那另外就是說我們要鼓勵給民眾提供分流分級的一個就醫的一個資訊就是緊急趕快處理因為醫院遵守那麼多遵守醫師公會也發表過幾度的聲明所以我們希望就是說如果只有\n\n17\n00:06:10,254 --> 00:06:26,985\n一般的感冒症狀可以先到診所來那如果這樣才不會影響到急診的一個量能所以部長上連假期間就春節連假期間就已經知道我們的就醫人數因為流感而增加了所以按理來講要放假了\n\n18\n00:06:28,067 --> 00:06:54,914\n前面有沒有預期就是在這個假期期間本來這個醫療的那個需求就是比較大的如果事前緊急我們的疫苗採購鼓勵施打並鼓勵過年期間減少休整的數量是不是就會比較不嚴重所以想問說你過年前有沒有看到這樣子預料到這些問題會發生因為已經前面就已經開始過年前已經有人開始事實上\n\n19\n00:06:55,314 --> 00:07:22,884\n感冒然后就医的比例上也比较高一点所以会不会做了什么在事前准备这一块好谢谢我刚刚有跟委员报告我们在事前就是有发表记者会宣称说那个大概要打疫苗过年的时候要洗手戴口罩到处都是这个都是常规大概这十年来每一次都有的对常规可是有没有更加强去做宣导公司部门那当然我们疫情如果\n\n20\n00:07:23,664 --> 00:07:51,977\n如果說有可能會尤其是這次會有免疫負債的現象我們COVID下來以後可能我們很擔心所以我們這次的確有加強包括成立傳染病在急診成立傳染病的門診包括我們鼓勵所有的院所如果你開診假日開診增加30%等等這都是屬於預防性的措施那但是我們的民眾還是會比較直接到大醫院來那其實有些是不是可以考慮\n\n21\n00:07:54,278 --> 00:08:10,584\n給民眾說其實我們診所都是非常優秀的說實在的我們在急診看的醫師全部都是在開業的醫師的學生所以我會鼓勵說大家還是有不舒服其實不是說鼓勵的應該\n\n22\n00:08:12,145 --> 00:08:27,595\n就應該大家都有一個家庭醫師的一個制度他就是先問他的家庭醫師我們在COVID的時候疫情台北市一天有曾經一萬個infected的可是他可以在家裡為什麼因為他都有\n\n23\n00:08:28,115 --> 00:08:47,855\n熟悉的醫師用視訊來看他在穩定他所以我們度過了大流行的一個難關那個剛剛講的事實上是我們的醫療用篩可是現在我們還在看病床的所以急診室在調度病床主要是透過我們為服務部建置的\n\n24\n00:08:48,584 --> 00:09:17,099\n重度級的急診急救責任醫院的急診及時訊息查詢跟14急診轉診的網絡跟六區緊急的醫療應變中心可是但是即時系統沒有辦法隨時更新所以注意不大那急診轉診網絡應變中心針對的特殊疾病並不一定有效最終最後呢就變成事實上是醫學中心自己自行相互聯絡\n\n25\n00:09:18,682 --> 00:09:42,691\n來致力救濟所以也想問一下副長順利轉院便可避免擁塞那只要醫院缺床缺ICU那特殊疾病的醫治的病床就有轉院的需求的時候這個問題一直沒有解決也沒有一直沒有提出來討論所以衛福部到底有什麼樣的對策\n\n26\n00:09:43,951 --> 00:09:59,891\n我們在中,謝謝委員對醫療狀況相當的了解那我們除了預防急性以外,當然改善護理人力的一個工作環境跟怎麼樣留任護理人力是我們國家重要政策,我們有時候向的措施\n\n27\n00:10:01,432 --> 00:10:25,898\n政府也提供經費那當然我們也非常樂意跟護理的團體來陸續因為護理團體有幾個護理團體我們都可以非常歡迎大家一起來討論總是把它改善到這個措施是真的能夠改善護理的待遇跟人力所以希望部長也要通受快好否則我覺得接下來還是一樣會面對同樣的問題對我們這個部分一定加強努力好\n\n28\n00:10:28,004 --> 00:10:30,435\n向下轉診做得好的話就可以紓解\n\n29\n00:10:31,717 --> 00:10:57,117\n醫院的負擔可是台灣缺乏我們的醫院的守門員的一個角色民眾可以自由選擇就醫的醫院所以就一直導致民眾常常不分輕重的習慣就到醫學中心去了或區醫院看病也往往造成我們的醫院擁塞衛福部向下轉診的分級醫院一直都沒有做好所以請問一下部長這一次我們的急診擁塞事件急診醫院似乎\n\n30\n00:10:57,897 --> 00:11:13,796\n沒有被納入在轉診的體系裡面尤其是分級醫療的架構裡面輕症本來就是基層的醫療的範疇所以衛福部對這個有沒有改善的措施大家委員我們非常重視各層級的角色\n\n31\n00:11:14,915 --> 00:11:30,357\n區醫院的區醫院他的重要的分流角色第七院更是有燈塔型的味道而且他可以協助基層醫療很多的不管是住院或者是急診的部分所以我們在第七院方面不管是在幾乎在怎麼樣都會跟第七院的\n\n32\n00:11:31,092 --> 00:11:44,949\n的一個協會做最好的一個處理我想這個陸續都溝通的相當的好重點是在基層醫療其實是有我們台灣的基層醫療是世界有名也強大的所以如何讓民眾也能夠\n\n33\n00:11:46,720 --> 00:12:14,337\n第一線就先使用基層藥你就有一個醫生的好朋友引後發燒引後肚子不舒服你如果有一個在就近的醫療院所仍然能夠幫你解決問題我相信他有必要的話轉診的也會比較快不然你叫一個白人跟你便宜也不太適合因為你要掛對科我肚子有點不舒服到底是要掛心臟科肚子科如果有一個先面有一個鎖門眼幫你鎖住\n\n34\n00:12:15,557 --> 00:12:36,285\n這個才是世界所說的聰明就醫啦謝謝委員的提醒我們每一個級每一個層級都有它重要的角色我們都會去發揮所以最後希望廉價你的準備應該要確實所以未來避免有廉價的期間造成急診的擁塞還有醫院轉診這個問題要及時要因應整個的緊急狀況\n\n35\n00:12:40,697 --> 00:12:52,419\n那分級醫院還是期待趕快讓民眾瞭解然後這個可以到他適合的去就診那在病床量能要提升來強化人力\n\n36\n00:12:52,918 --> 00:13:19,853\n床位監控還有預防擁塞所以委員您的指教就是我過去幾十年來從醫學院從醫師公會理事長從當立委到現在所希望幫國家做的事情我們一定有堅定的意志一定要去把它徹底解決這個問題希望大家一起來所以今天的質詢報告就今天我那四個主張在兩週內請馬\n\n37\n00:13:22,235 --> 00:13:30,994\n把這個訴求能夠提出書面報告然後還是要跟主席抗議一下因為前面是可以講到20分鐘以上謝謝\n\n","tsv":"start\tend\ttext\n4720\t6783\t麻煩邱部長邱部長請委員長\n16597\t41474\t今年2月22號我們臺灣急診醫學會就發出我們的政策聲明表示我們的急診用篩已達到前所未有的嚴重程度如果這問題持續的話大概會引發到我們的醫護人員大規模的離職甚至會進一步削弱我們醫療體系的承受能力所以急診室用篩有原因事實上是\n43293\t63271\t醫療擁塞跟我們的病床擁塞不過這次事件大概是春節期間大概七天很多門診事實上是休診的所以導致了我們的延伸到的醫療擁塞可是隨著假期結束之後照理來講應該是緩解了可是到2月22號還不能紓解的應該事實上是病床擁塞\n66033\t93114\t一直以來我們看到是過去本來就是這個就存在的一種現象也就是醫護人員招不滿的話就導致病床開不出來所以呢民眾平日的預約住院就要排隊個三五天那這一次的我們的普通病床跟ICU一路回堵到急診室問題才會這麼嚴重所以想問部長事件持續這麼長的時間那外界呢對衛福部處理的\n94391\t97099\t動作覺得太緩慢你作何解釋其實\n101595\t130556\t我們都有預防性的處理,譬如說在春節前其實不只公部門,我們也都有醫師公會已經連續七八年了,都在急診前都要譬如說要大家打預防針,要大家就診的一個怎麼樣分流然後我們在不管是健保署或疾管署都有提供經費給急診去開譬如說專人病房一個門診另外一個人力然後也鼓勵我們的急診診所能夠在\n131434\t156110\t假日的時候能夠多開診 而且都給他多一點 譬如說三成的一個補助這個就是比較有預防性的 然後也當時政府也多買了10萬劑的流感疫苗讓大家能夠希望避免得到相關的傳染病我想預防的措施是非常重要的那長期來講怎麼樣 我們國家本來就一直在做分級分流\n157590\t178694\t區域聯防的體系這個一直在做面對急診的困境到年後還是這樣子的時候當然我們就必須要更積極所以從大概3月2號開始連續我們到現在也有至少5次的會議出席的人是包括各衛生局各醫院院長幾乎幾百個用線上的在討論怎麼來解決這個問題\n183255\t205751\t那當然也包括急診醫學會,所以我們提出了三個緊急趕快處理的,持續再做兩個中長程的第一個你院內趕快調度,拜託院方能夠看看譬如說門診住院的話,哪一檔看完就看完,回去進行梳理我們有一個理念,急診你說到底要待多久?\n206511\t220997\t居德病能夠越快住院越好啊這是最重要的理念你剛剛提你們開了很多會可是2月3號年假就結束了可是衛福部到2月8號才邀集我們的疾管署和22個縣市衛生局跟14個轉診的網絡醫院主持人\n224943\t249682\t跟六區的緊急醫療應變中心執行長來召開會議討論那這個時間點我們當然看到衛福部自己講說急診量從4.5萬人次就是降為2.1萬人次可是等待住院的人還是偏高所以2月22號我們的急診醫學會才會出來發表聲明那衛福部自己也承認說病床擁塞的問題還是很嚴重所以想問\n252245\t262538\t今天春節期間在急診室最擁塞的時候民眾等待床位超過一天是常態那急診擁塞事件當下衛福部有掌握嗎\n263812\t291239\t就在春節期間我們每一天都每15分鐘那衛福部做了什麼樣的應變措施當然一定是努力去應變那你的應變措施到底是什麼應變措施我剛剛跟委員報告第一個就是說希望讓急診的後床的人能夠減少第二個希望當然還有等候看診其實等候看診的人都不是那麼長我們每天可以去追溯data大概\n292259\t320917\t委員所講的超過1000個就是51家的一個醫院我們說統計51家大概如果平均有20個後床的大概就會超過1000個那基本上還是在那幾家啦我們第一名的永遠都是林和長庚台大、高一、高雄長庚其實看起來都比較常例前茅啦那這個部分我們當然希望這些醫院能夠去\n322078\t346551\t積極的去處理嘛那剛剛講的三個緊急的處理第一個就是說院內去調配這個部分有些醫院做得還不錯當然有些婦女人覺得說會承受更多的壓力這個部分我們也了解但是就是院方一定要去好好的溝通平常也要訓練好第二個我們當然區域聯訪很重要所以我們這個時候部醫院26家醫院也跟五個訓練也站出來\n347331\t369714\t呈上啟下不管是上面的那這個部分也吸收了不少那另外就是說我們要鼓勵給民眾提供分流分級的一個就醫的一個資訊就是緊急趕快處理因為醫院遵守那麼多遵守醫師公會也發表過幾度的聲明所以我們希望就是說如果只有\n370254\t386985\t一般的感冒症狀可以先到診所來那如果這樣才不會影響到急診的一個量能所以部長上連假期間就春節連假期間就已經知道我們的就醫人數因為流感而增加了所以按理來講要放假了\n388067\t414914\t前面有沒有預期就是在這個假期期間本來這個醫療的那個需求就是比較大的如果事前緊急我們的疫苗採購鼓勵施打並鼓勵過年期間減少休整的數量是不是就會比較不嚴重所以想問說你過年前有沒有看到這樣子預料到這些問題會發生因為已經前面就已經開始過年前已經有人開始事實上\n415314\t442884\t感冒然后就医的比例上也比较高一点所以会不会做了什么在事前准备这一块好谢谢我刚刚有跟委员报告我们在事前就是有发表记者会宣称说那个大概要打疫苗过年的时候要洗手戴口罩到处都是这个都是常规大概这十年来每一次都有的对常规可是有没有更加强去做宣导公司部门那当然我们疫情如果\n443664\t471977\t如果說有可能會尤其是這次會有免疫負債的現象我們COVID下來以後可能我們很擔心所以我們這次的確有加強包括成立傳染病在急診成立傳染病的門診包括我們鼓勵所有的院所如果你開診假日開診增加30%等等這都是屬於預防性的措施那但是我們的民眾還是會比較直接到大醫院來那其實有些是不是可以考慮\n474278\t490584\t給民眾說其實我們診所都是非常優秀的說實在的我們在急診看的醫師全部都是在開業的醫師的學生所以我會鼓勵說大家還是有不舒服其實不是說鼓勵的應該\n492145\t507595\t就應該大家都有一個家庭醫師的一個制度他就是先問他的家庭醫師我們在COVID的時候疫情台北市一天有曾經一萬個infected的可是他可以在家裡為什麼因為他都有\n508115\t527855\t熟悉的醫師用視訊來看他在穩定他所以我們度過了大流行的一個難關那個剛剛講的事實上是我們的醫療用篩可是現在我們還在看病床的所以急診室在調度病床主要是透過我們為服務部建置的\n528584\t557099\t重度級的急診急救責任醫院的急診及時訊息查詢跟14急診轉診的網絡跟六區緊急的醫療應變中心可是但是即時系統沒有辦法隨時更新所以注意不大那急診轉診網絡應變中心針對的特殊疾病並不一定有效最終最後呢就變成事實上是醫學中心自己自行相互聯絡\n558682\t582691\t來致力救濟所以也想問一下副長順利轉院便可避免擁塞那只要醫院缺床缺ICU那特殊疾病的醫治的病床就有轉院的需求的時候這個問題一直沒有解決也沒有一直沒有提出來討論所以衛福部到底有什麼樣的對策\n583951\t599891\t我們在中,謝謝委員對醫療狀況相當的了解那我們除了預防急性以外,當然改善護理人力的一個工作環境跟怎麼樣留任護理人力是我們國家重要政策,我們有時候向的措施\n601432\t625898\t政府也提供經費那當然我們也非常樂意跟護理的團體來陸續因為護理團體有幾個護理團體我們都可以非常歡迎大家一起來討論總是把它改善到這個措施是真的能夠改善護理的待遇跟人力所以希望部長也要通受快好否則我覺得接下來還是一樣會面對同樣的問題對 我們這個部分一定加強努力好\n628004\t630435\t向下轉診做得好的話就可以紓解\n631717\t657117\t醫院的負擔可是台灣缺乏我們的醫院的守門員的一個角色民眾可以自由選擇就醫的醫院所以就一直導致民眾常常不分輕重的習慣就到醫學中心去了或區醫院看病也往往造成我們的醫院擁塞衛福部向下轉診的分級醫院一直都沒有做好所以請問一下部長這一次我們的急診擁塞事件急診醫院似乎\n657897\t673796\t沒有被納入在轉診的體系裡面尤其是分級醫療的架構裡面輕症本來就是基層的醫療的範疇所以衛福部對這個有沒有改善的措施大家委員我們非常重視各層級的角色\n674915\t690357\t區醫院的區醫院他的重要的分流角色第七院更是有燈塔型的味道而且他可以協助基層醫療很多的不管是住院或者是急診的部分所以我們在第七院方面不管是在幾乎在怎麼樣都會跟第七院的\n691092\t704949\t的一個協會做最好的一個處理我想這個陸續都溝通的相當的好重點是在基層醫療其實是有我們台灣的基層醫療是世界有名也強大的所以如何讓民眾也能夠\n706720\t734337\t第一線就先使用基層藥你就有一個醫生的好朋友引後發燒引後肚子不舒服你如果有一個在就近的醫療院所仍然能夠幫你解決問題我相信他有必要的話轉診的也會比較快不然你叫一個白人跟你便宜也不太適合因為你要掛對科我肚子有點不舒服到底是要掛心臟科肚子科如果有一個先面有一個鎖門眼幫你鎖住\n735557\t756285\t這個才是世界所說的聰明就醫啦謝謝委員的提醒我們每一個級每一個層級都有它重要的角色我們都會去發揮所以最後希望廉價你的準備應該要確實所以未來避免有廉價的期間造成急診的擁塞還有醫院轉診這個問題要及時要因應整個的緊急狀況\n760697\t772419\t那分級醫院還是期待趕快讓民眾瞭解然後這個可以到他適合的去就診那在病床量能要提升來強化人力\n772918\t799853\t床位監控還有預防擁塞所以委員您的指教就是我過去幾十年來從醫學院從醫師公會理事長從當立委到現在所希望幫國家做的事情我們一定有堅定的意志一定要去把它徹底解決這個問題希望大家一起來所以今天的質詢報告就今天我那四個主張在兩週內請馬\n802235\t810994\t把這個訴求能夠提出書面報告然後還是要跟主席抗議一下因為前面是可以講到20分鐘以上謝謝\n","txt":"麻煩邱部長邱部長請委員長\n今年2月22號我們臺灣急診醫學會就發出我們的政策聲明表示我們的急診用篩已達到前所未有的嚴重程度如果這問題持續的話大概會引發到我們的醫護人員大規模的離職甚至會進一步削弱我們醫療體系的承受能力所以急診室用篩有原因事實上是\n醫療擁塞跟我們的病床擁塞不過這次事件大概是春節期間大概七天很多門診事實上是休診的所以導致了我們的延伸到的醫療擁塞可是隨著假期結束之後照理來講應該是緩解了可是到2月22號還不能紓解的應該事實上是病床擁塞\n一直以來我們看到是過去本來就是這個就存在的一種現象也就是醫護人員招不滿的話就導致病床開不出來所以呢民眾平日的預約住院就要排隊個三五天那這一次的我們的普通病床跟ICU一路回堵到急診室問題才會這麼嚴重所以想問部長事件持續這麼長的時間那外界呢對衛福部處理的\n動作覺得太緩慢你作何解釋其實\n我們都有預防性的處理,譬如說在春節前其實不只公部門,我們也都有醫師公會已經連續七八年了,都在急診前都要譬如說要大家打預防針,要大家就診的一個怎麼樣分流然後我們在不管是健保署或疾管署都有提供經費給急診去開譬如說專人病房一個門診另外一個人力然後也鼓勵我們的急診診所能夠在\n假日的時候能夠多開診 而且都給他多一點 譬如說三成的一個補助這個就是比較有預防性的 然後也當時政府也多買了10萬劑的流感疫苗讓大家能夠希望避免得到相關的傳染病我想預防的措施是非常重要的那長期來講怎麼樣 我們國家本來就一直在做分級分流\n區域聯防的體系這個一直在做面對急診的困境到年後還是這樣子的時候當然我們就必須要更積極所以從大概3月2號開始連續我們到現在也有至少5次的會議出席的人是包括各衛生局各醫院院長幾乎幾百個用線上的在討論怎麼來解決這個問題\n那當然也包括急診醫學會,所以我們提出了三個緊急趕快處理的,持續再做兩個中長程的第一個你院內趕快調度,拜託院方能夠看看譬如說門診住院的話,哪一檔看完就看完,回去進行梳理我們有一個理念,急診你說到底要待多久?\n居德病能夠越快住院越好啊這是最重要的理念你剛剛提你們開了很多會可是2月3號年假就結束了可是衛福部到2月8號才邀集我們的疾管署和22個縣市衛生局跟14個轉診的網絡醫院主持人\n跟六區的緊急醫療應變中心執行長來召開會議討論那這個時間點我們當然看到衛福部自己講說急診量從4.5萬人次就是降為2.1萬人次可是等待住院的人還是偏高所以2月22號我們的急診醫學會才會出來發表聲明那衛福部自己也承認說病床擁塞的問題還是很嚴重所以想問\n今天春節期間在急診室最擁塞的時候民眾等待床位超過一天是常態那急診擁塞事件當下衛福部有掌握嗎\n就在春節期間我們每一天都每15分鐘那衛福部做了什麼樣的應變措施當然一定是努力去應變那你的應變措施到底是什麼應變措施我剛剛跟委員報告第一個就是說希望讓急診的後床的人能夠減少第二個希望當然還有等候看診其實等候看診的人都不是那麼長我們每天可以去追溯data大概\n委員所講的超過1000個就是51家的一個醫院我們說統計51家大概如果平均有20個後床的大概就會超過1000個那基本上還是在那幾家啦我們第一名的永遠都是林和長庚台大、高一、高雄長庚其實看起來都比較常例前茅啦那這個部分我們當然希望這些醫院能夠去\n積極的去處理嘛那剛剛講的三個緊急的處理第一個就是說院內去調配這個部分有些醫院做得還不錯當然有些婦女人覺得說會承受更多的壓力這個部分我們也了解但是就是院方一定要去好好的溝通平常也要訓練好第二個我們當然區域聯訪很重要所以我們這個時候部醫院26家醫院也跟五個訓練也站出來\n呈上啟下不管是上面的那這個部分也吸收了不少那另外就是說我們要鼓勵給民眾提供分流分級的一個就醫的一個資訊就是緊急趕快處理因為醫院遵守那麼多遵守醫師公會也發表過幾度的聲明所以我們希望就是說如果只有\n一般的感冒症狀可以先到診所來那如果這樣才不會影響到急診的一個量能所以部長上連假期間就春節連假期間就已經知道我們的就醫人數因為流感而增加了所以按理來講要放假了\n前面有沒有預期就是在這個假期期間本來這個醫療的那個需求就是比較大的如果事前緊急我們的疫苗採購鼓勵施打並鼓勵過年期間減少休整的數量是不是就會比較不嚴重所以想問說你過年前有沒有看到這樣子預料到這些問題會發生因為已經前面就已經開始過年前已經有人開始事實上\n感冒然后就医的比例上也比较高一点所以会不会做了什么在事前准备这一块好谢谢我刚刚有跟委员报告我们在事前就是有发表记者会宣称说那个大概要打疫苗过年的时候要洗手戴口罩到处都是这个都是常规大概这十年来每一次都有的对常规可是有没有更加强去做宣导公司部门那当然我们疫情如果\n如果說有可能會尤其是這次會有免疫負債的現象我們COVID下來以後可能我們很擔心所以我們這次的確有加強包括成立傳染病在急診成立傳染病的門診包括我們鼓勵所有的院所如果你開診假日開診增加30%等等這都是屬於預防性的措施那但是我們的民眾還是會比較直接到大醫院來那其實有些是不是可以考慮\n給民眾說其實我們診所都是非常優秀的說實在的我們在急診看的醫師全部都是在開業的醫師的學生所以我會鼓勵說大家還是有不舒服其實不是說鼓勵的應該\n就應該大家都有一個家庭醫師的一個制度他就是先問他的家庭醫師我們在COVID的時候疫情台北市一天有曾經一萬個infected的可是他可以在家裡為什麼因為他都有\n熟悉的醫師用視訊來看他在穩定他所以我們度過了大流行的一個難關那個剛剛講的事實上是我們的醫療用篩可是現在我們還在看病床的所以急診室在調度病床主要是透過我們為服務部建置的\n重度級的急診急救責任醫院的急診及時訊息查詢跟14急診轉診的網絡跟六區緊急的醫療應變中心可是但是即時系統沒有辦法隨時更新所以注意不大那急診轉診網絡應變中心針對的特殊疾病並不一定有效最終最後呢就變成事實上是醫學中心自己自行相互聯絡\n來致力救濟所以也想問一下副長順利轉院便可避免擁塞那只要醫院缺床缺ICU那特殊疾病的醫治的病床就有轉院的需求的時候這個問題一直沒有解決也沒有一直沒有提出來討論所以衛福部到底有什麼樣的對策\n我們在中,謝謝委員對醫療狀況相當的了解那我們除了預防急性以外,當然改善護理人力的一個工作環境跟怎麼樣留任護理人力是我們國家重要政策,我們有時候向的措施\n政府也提供經費那當然我們也非常樂意跟護理的團體來陸續因為護理團體有幾個護理團體我們都可以非常歡迎大家一起來討論總是把它改善到這個措施是真的能夠改善護理的待遇跟人力所以希望部長也要通受快好否則我覺得接下來還是一樣會面對同樣的問題對 我們這個部分一定加強努力好\n向下轉診做得好的話就可以紓解\n醫院的負擔可是台灣缺乏我們的醫院的守門員的一個角色民眾可以自由選擇就醫的醫院所以就一直導致民眾常常不分輕重的習慣就到醫學中心去了或區醫院看病也往往造成我們的醫院擁塞衛福部向下轉診的分級醫院一直都沒有做好所以請問一下部長這一次我們的急診擁塞事件急診醫院似乎\n沒有被納入在轉診的體系裡面尤其是分級醫療的架構裡面輕症本來就是基層的醫療的範疇所以衛福部對這個有沒有改善的措施大家委員我們非常重視各層級的角色\n區醫院的區醫院他的重要的分流角色第七院更是有燈塔型的味道而且他可以協助基層醫療很多的不管是住院或者是急診的部分所以我們在第七院方面不管是在幾乎在怎麼樣都會跟第七院的\n的一個協會做最好的一個處理我想這個陸續都溝通的相當的好重點是在基層醫療其實是有我們台灣的基層醫療是世界有名也強大的所以如何讓民眾也能夠\n第一線就先使用基層藥你就有一個醫生的好朋友引後發燒引後肚子不舒服你如果有一個在就近的醫療院所仍然能夠幫你解決問題我相信他有必要的話轉診的也會比較快不然你叫一個白人跟你便宜也不太適合因為你要掛對科我肚子有點不舒服到底是要掛心臟科肚子科如果有一個先面有一個鎖門眼幫你鎖住\n這個才是世界所說的聰明就醫啦謝謝委員的提醒我們每一個級每一個層級都有它重要的角色我們都會去發揮所以最後希望廉價你的準備應該要確實所以未來避免有廉價的期間造成急診的擁塞還有醫院轉診這個問題要及時要因應整個的緊急狀況\n那分級醫院還是期待趕快讓民眾瞭解然後這個可以到他適合的去就診那在病床量能要提升來強化人力\n床位監控還有預防擁塞所以委員您的指教就是我過去幾十年來從醫學院從醫師公會理事長從當立委到現在所希望幫國家做的事情我們一定有堅定的意志一定要去把它徹底解決這個問題希望大家一起來所以今天的質詢報告就今天我那四個主張在兩週內請馬\n把這個訴求能夠提出書面報告然後還是要跟主席抗議一下因為前面是可以講到20分鐘以上謝謝\n","vtt":"WEBVTT\n\n00:04.720 --> 00:06.783\n麻煩邱部長邱部長請委員長\n\n00:16.597 --> 00:41.474\n今年2月22號我們臺灣急診醫學會就發出我們的政策聲明表示我們的急診用篩已達到前所未有的嚴重程度如果這問題持續的話大概會引發到我們的醫護人員大規模的離職甚至會進一步削弱我們醫療體系的承受能力所以急診室用篩有原因事實上是\n\n00:43.293 --> 01:03.271\n醫療擁塞跟我們的病床擁塞不過這次事件大概是春節期間大概七天很多門診事實上是休診的所以導致了我們的延伸到的醫療擁塞可是隨著假期結束之後照理來講應該是緩解了可是到2月22號還不能紓解的應該事實上是病床擁塞\n\n01:06.033 --> 01:33.114\n一直以來我們看到是過去本來就是這個就存在的一種現象也就是醫護人員招不滿的話就導致病床開不出來所以呢民眾平日的預約住院就要排隊個三五天那這一次的我們的普通病床跟ICU一路回堵到急診室問題才會這麼嚴重所以想問部長事件持續這麼長的時間那外界呢對衛福部處理的\n\n01:34.391 --> 01:37.099\n動作覺得太緩慢你作何解釋其實\n\n01:41.595 --> 02:10.556\n我們都有預防性的處理,譬如說在春節前其實不只公部門,我們也都有醫師公會已經連續七八年了,都在急診前都要譬如說要大家打預防針,要大家就診的一個怎麼樣分流然後我們在不管是健保署或疾管署都有提供經費給急診去開譬如說專人病房一個門診另外一個人力然後也鼓勵我們的急診診所能夠在\n\n02:11.434 --> 02:36.110\n假日的時候能夠多開診而且都給他多一點譬如說三成的一個補助這個就是比較有預防性的然後也當時政府也多買了10萬劑的流感疫苗讓大家能夠希望避免得到相關的傳染病我想預防的措施是非常重要的那長期來講怎麼樣我們國家本來就一直在做分級分流\n\n02:37.590 --> 02:58.694\n區域聯防的體系這個一直在做面對急診的困境到年後還是這樣子的時候當然我們就必須要更積極所以從大概3月2號開始連續我們到現在也有至少5次的會議出席的人是包括各衛生局各醫院院長幾乎幾百個用線上的在討論怎麼來解決這個問題\n\n03:03.255 --> 03:25.751\n那當然也包括急診醫學會,所以我們提出了三個緊急趕快處理的,持續再做兩個中長程的第一個你院內趕快調度,拜託院方能夠看看譬如說門診住院的話,哪一檔看完就看完,回去進行梳理我們有一個理念,急診你說到底要待多久?\n\n03:26.511 --> 03:40.997\n居德病能夠越快住院越好啊這是最重要的理念你剛剛提你們開了很多會可是2月3號年假就結束了可是衛福部到2月8號才邀集我們的疾管署和22個縣市衛生局跟14個轉診的網絡醫院主持人\n\n03:44.943 --> 04:09.682\n跟六區的緊急醫療應變中心執行長來召開會議討論那這個時間點我們當然看到衛福部自己講說急診量從4.5萬人次就是降為2.1萬人次可是等待住院的人還是偏高所以2月22號我們的急診醫學會才會出來發表聲明那衛福部自己也承認說病床擁塞的問題還是很嚴重所以想問\n\n04:12.245 --> 04:22.538\n今天春節期間在急診室最擁塞的時候民眾等待床位超過一天是常態那急診擁塞事件當下衛福部有掌握嗎\n\n04:23.812 --> 04:51.239\n就在春節期間我們每一天都每15分鐘那衛福部做了什麼樣的應變措施當然一定是努力去應變那你的應變措施到底是什麼應變措施我剛剛跟委員報告第一個就是說希望讓急診的後床的人能夠減少第二個希望當然還有等候看診其實等候看診的人都不是那麼長我們每天可以去追溯data大概\n\n04:52.259 --> 05:20.917\n委員所講的超過1000個就是51家的一個醫院我們說統計51家大概如果平均有20個後床的大概就會超過1000個那基本上還是在那幾家啦我們第一名的永遠都是林和長庚台大、高一、高雄長庚其實看起來都比較常例前茅啦那這個部分我們當然希望這些醫院能夠去\n\n05:22.078 --> 05:46.551\n積極的去處理嘛那剛剛講的三個緊急的處理第一個就是說院內去調配這個部分有些醫院做得還不錯當然有些婦女人覺得說會承受更多的壓力這個部分我們也了解但是就是院方一定要去好好的溝通平常也要訓練好第二個我們當然區域聯訪很重要所以我們這個時候部醫院26家醫院也跟五個訓練也站出來\n\n05:47.331 --> 06:09.714\n呈上啟下不管是上面的那這個部分也吸收了不少那另外就是說我們要鼓勵給民眾提供分流分級的一個就醫的一個資訊就是緊急趕快處理因為醫院遵守那麼多遵守醫師公會也發表過幾度的聲明所以我們希望就是說如果只有\n\n06:10.254 --> 06:26.985\n一般的感冒症狀可以先到診所來那如果這樣才不會影響到急診的一個量能所以部長上連假期間就春節連假期間就已經知道我們的就醫人數因為流感而增加了所以按理來講要放假了\n\n06:28.067 --> 06:54.914\n前面有沒有預期就是在這個假期期間本來這個醫療的那個需求就是比較大的如果事前緊急我們的疫苗採購鼓勵施打並鼓勵過年期間減少休整的數量是不是就會比較不嚴重所以想問說你過年前有沒有看到這樣子預料到這些問題會發生因為已經前面就已經開始過年前已經有人開始事實上\n\n06:55.314 --> 07:22.884\n感冒然后就医的比例上也比较高一点所以会不会做了什么在事前准备这一块好谢谢我刚刚有跟委员报告我们在事前就是有发表记者会宣称说那个大概要打疫苗过年的时候要洗手戴口罩到处都是这个都是常规大概这十年来每一次都有的对常规可是有没有更加强去做宣导公司部门那当然我们疫情如果\n\n07:23.664 --> 07:51.977\n如果說有可能會尤其是這次會有免疫負債的現象我們COVID下來以後可能我們很擔心所以我們這次的確有加強包括成立傳染病在急診成立傳染病的門診包括我們鼓勵所有的院所如果你開診假日開診增加30%等等這都是屬於預防性的措施那但是我們的民眾還是會比較直接到大醫院來那其實有些是不是可以考慮\n\n07:54.278 --> 08:10.584\n給民眾說其實我們診所都是非常優秀的說實在的我們在急診看的醫師全部都是在開業的醫師的學生所以我會鼓勵說大家還是有不舒服其實不是說鼓勵的應該\n\n08:12.145 --> 08:27.595\n就應該大家都有一個家庭醫師的一個制度他就是先問他的家庭醫師我們在COVID的時候疫情台北市一天有曾經一萬個infected的可是他可以在家裡為什麼因為他都有\n\n08:28.115 --> 08:47.855\n熟悉的醫師用視訊來看他在穩定他所以我們度過了大流行的一個難關那個剛剛講的事實上是我們的醫療用篩可是現在我們還在看病床的所以急診室在調度病床主要是透過我們為服務部建置的\n\n08:48.584 --> 09:17.099\n重度級的急診急救責任醫院的急診及時訊息查詢跟14急診轉診的網絡跟六區緊急的醫療應變中心可是但是即時系統沒有辦法隨時更新所以注意不大那急診轉診網絡應變中心針對的特殊疾病並不一定有效最終最後呢就變成事實上是醫學中心自己自行相互聯絡\n\n09:18.682 --> 09:42.691\n來致力救濟所以也想問一下副長順利轉院便可避免擁塞那只要醫院缺床缺ICU那特殊疾病的醫治的病床就有轉院的需求的時候這個問題一直沒有解決也沒有一直沒有提出來討論所以衛福部到底有什麼樣的對策\n\n09:43.951 --> 09:59.891\n我們在中,謝謝委員對醫療狀況相當的了解那我們除了預防急性以外,當然改善護理人力的一個工作環境跟怎麼樣留任護理人力是我們國家重要政策,我們有時候向的措施\n\n10:01.432 --> 10:25.898\n政府也提供經費那當然我們也非常樂意跟護理的團體來陸續因為護理團體有幾個護理團體我們都可以非常歡迎大家一起來討論總是把它改善到這個措施是真的能夠改善護理的待遇跟人力所以希望部長也要通受快好否則我覺得接下來還是一樣會面對同樣的問題對我們這個部分一定加強努力好\n\n10:28.004 --> 10:30.435\n向下轉診做得好的話就可以紓解\n\n10:31.717 --> 10:57.117\n醫院的負擔可是台灣缺乏我們的醫院的守門員的一個角色民眾可以自由選擇就醫的醫院所以就一直導致民眾常常不分輕重的習慣就到醫學中心去了或區醫院看病也往往造成我們的醫院擁塞衛福部向下轉診的分級醫院一直都沒有做好所以請問一下部長這一次我們的急診擁塞事件急診醫院似乎\n\n10:57.897 --> 11:13.796\n沒有被納入在轉診的體系裡面尤其是分級醫療的架構裡面輕症本來就是基層的醫療的範疇所以衛福部對這個有沒有改善的措施大家委員我們非常重視各層級的角色\n\n11:14.915 --> 11:30.357\n區醫院的區醫院他的重要的分流角色第七院更是有燈塔型的味道而且他可以協助基層醫療很多的不管是住院或者是急診的部分所以我們在第七院方面不管是在幾乎在怎麼樣都會跟第七院的\n\n11:31.092 --> 11:44.949\n的一個協會做最好的一個處理我想這個陸續都溝通的相當的好重點是在基層醫療其實是有我們台灣的基層醫療是世界有名也強大的所以如何讓民眾也能夠\n\n11:46.720 --> 12:14.337\n第一線就先使用基層藥你就有一個醫生的好朋友引後發燒引後肚子不舒服你如果有一個在就近的醫療院所仍然能夠幫你解決問題我相信他有必要的話轉診的也會比較快不然你叫一個白人跟你便宜也不太適合因為你要掛對科我肚子有點不舒服到底是要掛心臟科肚子科如果有一個先面有一個鎖門眼幫你鎖住\n\n12:15.557 --> 12:36.285\n這個才是世界所說的聰明就醫啦謝謝委員的提醒我們每一個級每一個層級都有它重要的角色我們都會去發揮所以最後希望廉價你的準備應該要確實所以未來避免有廉價的期間造成急診的擁塞還有醫院轉診這個問題要及時要因應整個的緊急狀況\n\n12:40.697 --> 12:52.419\n那分級醫院還是期待趕快讓民眾瞭解然後這個可以到他適合的去就診那在病床量能要提升來強化人力\n\n12:52.918 --> 13:19.853\n床位監控還有預防擁塞所以委員您的指教就是我過去幾十年來從醫學院從醫師公會理事長從當立委到現在所希望幫國家做的事情我們一定有堅定的意志一定要去把它徹底解決這個問題希望大家一起來所以今天的質詢報告就今天我那四個主張在兩週內請馬\n\n13:22.235 --> 13:30.994\n把這個訴求能夠提出書面報告然後還是要跟主席抗議一下因為前面是可以講到20分鐘以上謝謝\n\n","segments":[{"start":4.72,"end":6.783,"text":"麻煩邱部長邱部長請委員長"},{"start":16.597,"end":41.474,"text":"今年2月22號我們臺灣急診醫學會就發出我們的政策聲明表示我們的急診用篩已達到前所未有的嚴重程度如果這問題持續的話大概會引發到我們的醫護人員大規模的離職甚至會進一步削弱我們醫療體系的承受能力所以急診室用篩有原因事實上是"},{"start":43.293,"end":63.271,"text":"醫療擁塞跟我們的病床擁塞不過這次事件大概是春節期間大概七天很多門診事實上是休診的所以導致了我們的延伸到的醫療擁塞可是隨著假期結束之後照理來講應該是緩解了可是到2月22號還不能紓解的應該事實上是病床擁塞"},{"start":66.033,"end":93.114,"text":"一直以來我們看到是過去本來就是這個就存在的一種現象也就是醫護人員招不滿的話就導致病床開不出來所以呢民眾平日的預約住院就要排隊個三五天那這一次的我們的普通病床跟ICU一路回堵到急診室問題才會這麼嚴重所以想問部長事件持續這麼長的時間那外界呢對衛福部處理的"},{"start":94.391,"end":97.099,"text":"動作覺得太緩慢你作何解釋其實"},{"start":101.595,"end":130.556,"text":"我們都有預防性的處理,譬如說在春節前其實不只公部門,我們也都有醫師公會已經連續七八年了,都在急診前都要譬如說要大家打預防針,要大家就診的一個怎麼樣分流然後我們在不管是健保署或疾管署都有提供經費給急診去開譬如說專人病房一個門診另外一個人力然後也鼓勵我們的急診診所能夠在"},{"start":131.434,"end":156.11,"text":"假日的時候能夠多開診 而且都給他多一點 譬如說三成的一個補助這個就是比較有預防性的 然後也當時政府也多買了10萬劑的流感疫苗讓大家能夠希望避免得到相關的傳染病我想預防的措施是非常重要的那長期來講怎麼樣 我們國家本來就一直在做分級分流"},{"start":157.59,"end":178.694,"text":"區域聯防的體系這個一直在做面對急診的困境到年後還是這樣子的時候當然我們就必須要更積極所以從大概3月2號開始連續我們到現在也有至少5次的會議出席的人是包括各衛生局各醫院院長幾乎幾百個用線上的在討論怎麼來解決這個問題"},{"start":183.255,"end":205.751,"text":"那當然也包括急診醫學會,所以我們提出了三個緊急趕快處理的,持續再做兩個中長程的第一個你院內趕快調度,拜託院方能夠看看譬如說門診住院的話,哪一檔看完就看完,回去進行梳理我們有一個理念,急診你說到底要待多久?"},{"start":206.511,"end":220.997,"text":"居德病能夠越快住院越好啊這是最重要的理念你剛剛提你們開了很多會可是2月3號年假就結束了可是衛福部到2月8號才邀集我們的疾管署和22個縣市衛生局跟14個轉診的網絡醫院主持人"},{"start":224.943,"end":249.682,"text":"跟六區的緊急醫療應變中心執行長來召開會議討論那這個時間點我們當然看到衛福部自己講說急診量從4.5萬人次就是降為2.1萬人次可是等待住院的人還是偏高所以2月22號我們的急診醫學會才會出來發表聲明那衛福部自己也承認說病床擁塞的問題還是很嚴重所以想問"},{"start":252.245,"end":262.538,"text":"今天春節期間在急診室最擁塞的時候民眾等待床位超過一天是常態那急診擁塞事件當下衛福部有掌握嗎"},{"start":263.812,"end":291.239,"text":"就在春節期間我們每一天都每15分鐘那衛福部做了什麼樣的應變措施當然一定是努力去應變那你的應變措施到底是什麼應變措施我剛剛跟委員報告第一個就是說希望讓急診的後床的人能夠減少第二個希望當然還有等候看診其實等候看診的人都不是那麼長我們每天可以去追溯data大概"},{"start":292.259,"end":320.917,"text":"委員所講的超過1000個就是51家的一個醫院我們說統計51家大概如果平均有20個後床的大概就會超過1000個那基本上還是在那幾家啦我們第一名的永遠都是林和長庚台大、高一、高雄長庚其實看起來都比較常例前茅啦那這個部分我們當然希望這些醫院能夠去"},{"start":322.078,"end":346.551,"text":"積極的去處理嘛那剛剛講的三個緊急的處理第一個就是說院內去調配這個部分有些醫院做得還不錯當然有些婦女人覺得說會承受更多的壓力這個部分我們也了解但是就是院方一定要去好好的溝通平常也要訓練好第二個我們當然區域聯訪很重要所以我們這個時候部醫院26家醫院也跟五個訓練也站出來"},{"start":347.331,"end":369.714,"text":"呈上啟下不管是上面的那這個部分也吸收了不少那另外就是說我們要鼓勵給民眾提供分流分級的一個就醫的一個資訊就是緊急趕快處理因為醫院遵守那麼多遵守醫師公會也發表過幾度的聲明所以我們希望就是說如果只有"},{"start":370.254,"end":386.985,"text":"一般的感冒症狀可以先到診所來那如果這樣才不會影響到急診的一個量能所以部長上連假期間就春節連假期間就已經知道我們的就醫人數因為流感而增加了所以按理來講要放假了"},{"start":388.067,"end":414.914,"text":"前面有沒有預期就是在這個假期期間本來這個醫療的那個需求就是比較大的如果事前緊急我們的疫苗採購鼓勵施打並鼓勵過年期間減少休整的數量是不是就會比較不嚴重所以想問說你過年前有沒有看到這樣子預料到這些問題會發生因為已經前面就已經開始過年前已經有人開始事實上"},{"start":415.314,"end":442.884,"text":"感冒然后就医的比例上也比较高一点所以会不会做了什么在事前准备这一块好谢谢我刚刚有跟委员报告我们在事前就是有发表记者会宣称说那个大概要打疫苗过年的时候要洗手戴口罩到处都是这个都是常规大概这十年来每一次都有的对常规可是有没有更加强去做宣导公司部门那当然我们疫情如果"},{"start":443.664,"end":471.977,"text":"如果說有可能會尤其是這次會有免疫負債的現象我們COVID下來以後可能我們很擔心所以我們這次的確有加強包括成立傳染病在急診成立傳染病的門診包括我們鼓勵所有的院所如果你開診假日開診增加30%等等這都是屬於預防性的措施那但是我們的民眾還是會比較直接到大醫院來那其實有些是不是可以考慮"},{"start":474.278,"end":490.584,"text":"給民眾說其實我們診所都是非常優秀的說實在的我們在急診看的醫師全部都是在開業的醫師的學生所以我會鼓勵說大家還是有不舒服其實不是說鼓勵的應該"},{"start":492.145,"end":507.595,"text":"就應該大家都有一個家庭醫師的一個制度他就是先問他的家庭醫師我們在COVID的時候疫情台北市一天有曾經一萬個infected的可是他可以在家裡為什麼因為他都有"},{"start":508.115,"end":527.855,"text":"熟悉的醫師用視訊來看他在穩定他所以我們度過了大流行的一個難關那個剛剛講的事實上是我們的醫療用篩可是現在我們還在看病床的所以急診室在調度病床主要是透過我們為服務部建置的"},{"start":528.584,"end":557.099,"text":"重度級的急診急救責任醫院的急診及時訊息查詢跟14急診轉診的網絡跟六區緊急的醫療應變中心可是但是即時系統沒有辦法隨時更新所以注意不大那急診轉診網絡應變中心針對的特殊疾病並不一定有效最終最後呢就變成事實上是醫學中心自己自行相互聯絡"},{"start":558.682,"end":582.691,"text":"來致力救濟所以也想問一下副長順利轉院便可避免擁塞那只要醫院缺床缺ICU那特殊疾病的醫治的病床就有轉院的需求的時候這個問題一直沒有解決也沒有一直沒有提出來討論所以衛福部到底有什麼樣的對策"},{"start":583.951,"end":599.891,"text":"我們在中,謝謝委員對醫療狀況相當的了解那我們除了預防急性以外,當然改善護理人力的一個工作環境跟怎麼樣留任護理人力是我們國家重要政策,我們有時候向的措施"},{"start":601.432,"end":625.898,"text":"政府也提供經費那當然我們也非常樂意跟護理的團體來陸續因為護理團體有幾個護理團體我們都可以非常歡迎大家一起來討論總是把它改善到這個措施是真的能夠改善護理的待遇跟人力所以希望部長也要通受快好否則我覺得接下來還是一樣會面對同樣的問題對 我們這個部分一定加強努力好"},{"start":628.004,"end":630.435,"text":"向下轉診做得好的話就可以紓解"},{"start":631.717,"end":657.117,"text":"醫院的負擔可是台灣缺乏我們的醫院的守門員的一個角色民眾可以自由選擇就醫的醫院所以就一直導致民眾常常不分輕重的習慣就到醫學中心去了或區醫院看病也往往造成我們的醫院擁塞衛福部向下轉診的分級醫院一直都沒有做好所以請問一下部長這一次我們的急診擁塞事件急診醫院似乎"},{"start":657.897,"end":673.796,"text":"沒有被納入在轉診的體系裡面尤其是分級醫療的架構裡面輕症本來就是基層的醫療的範疇所以衛福部對這個有沒有改善的措施大家委員我們非常重視各層級的角色"},{"start":674.915,"end":690.357,"text":"區醫院的區醫院他的重要的分流角色第七院更是有燈塔型的味道而且他可以協助基層醫療很多的不管是住院或者是急診的部分所以我們在第七院方面不管是在幾乎在怎麼樣都會跟第七院的"},{"start":691.092,"end":704.949,"text":"的一個協會做最好的一個處理我想這個陸續都溝通的相當的好重點是在基層醫療其實是有我們台灣的基層醫療是世界有名也強大的所以如何讓民眾也能夠"},{"start":706.72,"end":734.337,"text":"第一線就先使用基層藥你就有一個醫生的好朋友引後發燒引後肚子不舒服你如果有一個在就近的醫療院所仍然能夠幫你解決問題我相信他有必要的話轉診的也會比較快不然你叫一個白人跟你便宜也不太適合因為你要掛對科我肚子有點不舒服到底是要掛心臟科肚子科如果有一個先面有一個鎖門眼幫你鎖住"},{"start":735.557,"end":756.285,"text":"這個才是世界所說的聰明就醫啦謝謝委員的提醒我們每一個級每一個層級都有它重要的角色我們都會去發揮所以最後希望廉價你的準備應該要確實所以未來避免有廉價的期間造成急診的擁塞還有醫院轉診這個問題要及時要因應整個的緊急狀況"},{"start":760.697,"end":772.419,"text":"那分級醫院還是期待趕快讓民眾瞭解然後這個可以到他適合的去就診那在病床量能要提升來強化人力"},{"start":772.918,"end":799.853,"text":"床位監控還有預防擁塞所以委員您的指教就是我過去幾十年來從醫學院從醫師公會理事長從當立委到現在所希望幫國家做的事情我們一定有堅定的意志一定要去把它徹底解決這個問題希望大家一起來所以今天的質詢報告就今天我那四個主張在兩週內請馬"},{"start":802.235,"end":810.994,"text":"把這個訴求能夠提出書面報告然後還是要跟主席抗議一下因為前面是可以講到20分鐘以上謝謝"}]}}},"gazette":{"lineno":224,"blocks":[["林委員月琴：（9時26分）麻煩請邱部長。"],["主席：邱部長，請。"],["邱部長泰源：委員早。"],["林委員月琴：部長早。今年2月22號台灣急診醫學會發出政策聲明表示，急診壅塞已達到前所未有的嚴重程度，如果這個問題持續的話，大概會引發醫護人員大規模離職，甚至會進一步削弱醫療體系的承受能力。急診室壅塞的原因是醫療壅塞跟病床壅塞，不過這次事件大概是因為春節期間7天有很多門診休診，導致醫療壅塞，隨著假期結束之後，照理來講應該是要緩解了，可是到2月22號還不能疏解，事實上應該是病床壅塞。一直以來我們看到的是過去本來就存在這種現象，也就是醫護人員招不滿的話，就導致病床開不出來，所以民眾平日的預約住院就要排隊三、五天，這一次我們的普通病床跟ICU一路回堵到急診室，問題才會這麼嚴重。所以想問部長，事件持續這麼長的時間，外界對衛福部處理的動作覺得太緩慢，你作何解釋？"],["邱部長泰源：謝謝委員，跟委員報告，其實我們都有預防性的處理，比如說在春節前，其實不只公部門，我們跟醫師公會已經連續七、八年都呼籲大家要打預防針、要大家就診分流，並且不管是健保署或疾管署都有提供經費給急診去開設比如像是傳染病門診，就是另外有個人力，然後也鼓勵我們的基層診所能夠在假日的時候多開診，而且都給他多一點補助，比如說三成的補助，這個就是比較預防性的，當時政府也多買了10萬劑的流感疫苗，避免民眾得到相關的傳染病，我想預防的措施是非常重要的。長期來講，我們國家本來就一直在做分級、分流的區域聯防體系，這個一直都在做。面對這樣的急診困境，到年後還是這樣的時候，當然我們就必須要更積極，所以大概從3月2號開始，我們到現在至少也開了5次的會議，出席人員包括各衛生局、各醫院院長，幾乎幾百個，用線上的方式在討論怎麼來解決這個問題，當然也包括急診醫學會，我們提出三個緊急處理措施，也持續在進行兩個中長程的策略。第一個就是院內趕快調度，拜託院方能夠評估，比如門診住院的如果可以慢一點就慢一點，讓急診先疏解。我們有一個理念，急診，你說到底要待多久？急診病人能夠越快出院越好啊，本來這就是最終的理念。"],["林委員月琴：部長，你剛剛提到你們開了很多會，2月3號年假就結束了，可是衛福部到2月8號才邀集疾管署、22個縣市衛生局及14個轉診網絡醫院主持人以及6區的緊急醫療應變中心執行長來召開會議討論，這個時間點，我們看到衛福部自己講說急診量從4.5萬人次降為2.7萬人次，但等待住院的人數還是偏高，所以2月22號急診醫學會才會出來發表聲明，衛福部自己也承認病床壅塞的問題還是很嚴重。所以想問部長，春節期間在急診室最壅塞的時候，民眾等待床位超過一天是常態，急診壅塞事件當下，衛福部有掌握嗎？就是在春節期間。"],["邱部長泰源：當然，我們每一天每15分鐘都……"],["林委員月琴：那衛福部做了什麼樣的應變措施？"],["邱部長泰源：當然一定是努力去應變……"],["林委員月琴：那你的應變措施到底是什麼？"],["邱部長泰源：應變措施我剛剛跟委員報告，第一個就是希望讓急診的候床人數能夠減少；第二個當然還有等候看診，其實等候看診的人時間都不是那麼長，我們每天可以去追溯data，委員所講的超過1,000個，就是51家的醫院，我們統計是51家，如果平均有20個候床的，大概就會超過1,000個，基本上還是在那幾家，第一名的永遠都是林口長庚，還有臺大、高醫、高雄長庚，其實看起來都比較名列前茅。這個部分我們當然也希望這些醫院能夠積極地處理，剛剛有提到三個緊急處理措施，第一個就是院內去調配，這部分有些醫院做得還不錯，當然有些護理人員覺得會承受更多壓力，這個部分我們也了解，但院方一定要好好地溝通，平常也要訓練好；第二個，當然區域聯防很重要，所以我們26家部立醫院跟5家分院也站出來，承上啟下，不管是上面的還是下面的，這個部分也吸收了不少；另外就是，我們要鼓勵民眾，提供分流、分級的就醫資訊，就是緊急趕快處理，因為診所那麼多，醫師公會也幾度發表聲明，希望如果只有一般的感冒症狀可以先到診所，這樣才不會影響到急診的量能。"],["林委員月琴：部長，春節連假期間就已經知道我們的就醫人數因為流感而增加了，按理來講要放假了，在這之前你有沒有預期在假期期間本來醫療需求就是比較大的？如果事前緊急進行疫苗採購並鼓勵施打，並鼓勵過年期間減少休診的數量，是不是就會比較不嚴重？所以想問的是，你過年前有沒有預料到這些問題會發生？因為過年前就已經有人開始感冒等等，在就醫比例上也比較高一點，所以在事前準備這一塊，衛福部做了什麼？"],["邱部長泰源：好，謝謝。我剛剛有跟委員報告，我們在事前也發表記者會宣導要打疫苗，過年的時候要洗手、戴口罩，這個都是常規，這十年來每一次都有，公私部門……"],["林委員月琴：對，常規，可是有沒有更加強去做宣導？"],["邱部長泰源：尤其是這次會有免疫負債的現象，在COVID-19之後，我們很擔心，所以我們這次的確有加強，包括在急診成立傳染病的門診，包括我們鼓勵所有的院所如果假日開診，增加30%補助等等，這些都是屬於預防性的措施，但是我們的民眾還是會比較直接到大醫院，其實有些是不是可以考慮，要跟民眾說，其實我們的診所都是非常優秀的，說實在的，我們在急診看診的醫師，全部都是在開業的醫師的學生，所以我會鼓勵大家有不舒服還是……其實不是鼓勵，應該是大家都有一個家庭醫師的制度，他就先去問他的家庭醫師，我們在COVID疫情的時候，臺北市一天曾經有1萬個infected，可是他可以在家裡，為什麼？因為他都有熟悉的醫師用視訊來看他、穩定他，所以我們度過了大流行的難關。"],["林委員月琴：好，剛才講的是我們上次的醫療壅塞，可是現在我們還是要談病床的部分，急診室調度病床主要是透過衛福部建置的重度級急救責任醫院急診即時訊息查詢、14個急診轉診網絡跟6區緊急醫療應變中心，但是即時系統沒有辦法隨時更新，所以助益不大，急診轉診網絡、應變中心針對特殊疾病並不一定有效，最終變成是醫學中心自行相互聯絡來自力救濟。","所以也想問一下部長，順利轉院便可避免壅塞，當醫院缺床、缺ICU、特殊疾病醫治的病床有轉院需求的時候，這個問題一直沒有解決、也一直沒有提出來討論，所以衛福部到底有什麼樣的對策？"],["邱部長泰源：謝謝委員對醫療狀況相當地了解，我們除了預防急性以外，當然改善護理人力的工作環境跟怎麼樣留任護理人力是我們國家的重要政策，我們有12項措施，政府也提供經費，當然這12項措施我們也非常樂意跟護理團體陸續……因為有幾個護理團體，我們都非常歡迎大家一起來討論，總是要把它改善到這個措施真的能夠改善護理的待遇跟人力。"],["林委員月琴：所以希望部長也要動作快，否則我覺得接下來還是會面對同樣的問題。"],["邱部長泰源：對，我們這個部分一定加強努力！"],["林委員月琴：好。上下轉診做得好的話就可以疏解醫院的負擔，可是臺灣缺乏醫院守門員的角色，民眾可以自由選擇就醫的醫院，所以一直導致民眾常常不分輕重的習慣，就到醫學中心或區域醫院看病，也往往造成醫院壅塞，衛福部向下轉診的分級醫療一直都沒有做好。所以請問一下部長，這一次我們的急診壅塞事件，基層醫院似乎沒有被納入轉診的體系裡面，尤其在分級醫療的架構裡面，輕症本來就是基層醫療的範疇，所以衛福部對這個有沒有改善的措施、精進作為？"],["邱部長泰源：報告委員，我們非常重視各層級的角色，區域醫院有區域醫院的重要分流角色；地區醫院更是有燈塔型的味道，而且它可以協助很多的基層醫療，不管是住院或者急診的部分，所以我們在地區醫院方面，不管是在給付等方面都會跟地區醫院協會做最好的處理，我想這部分陸續都溝通得相當好。","重點是在基層醫療，其實我們臺灣的基層醫療是世界有名、強大的，所以如何讓民眾也能夠第一線就先使用基層醫療，如果你有一個醫生的好朋友，任何發燒、肚子不舒服在就近的醫療院所能夠幫你解決問題，我相信有必要的話轉診也會比較快，不然一個病人自己去醫院也很茫然、不知道要掛哪一科，假如我肚子有點不舒服到底是要掛心臟科還是哪一科？如果下面有一個守門員幫你守住，這個才是世界所說的聰明就醫啦！謝謝委員的提醒，我們每一個層級都有它重要的角色，我們都會去發揮。"],["林委員月琴：好。最後，希望連假時你的準備應該要確實，未來避免連假期間造成急診的壅塞；還有醫院轉診這個問題也要及時因應整個緊急狀況；分級醫療還是期待趕快讓民眾了解，讓他可以到適合的醫療院所去就診；再來，病床量能要提升，強化人力、床位監控還有預防壅塞。"],["邱部長泰源：委員您的指教就是我過去幾十年來，從醫學院、從醫師公會理事長、從當立委到現在所希望幫國家做的事情，我們有堅定的意志一定要澈底解決這個問題，希望大家一起來。"],["林委員月琴：好。所以就我今天質詢的4個主張，在兩週內麻煩針對這些訴求提出書面報告。"],["邱部長泰源：好，沒問題，是。"],["林委員月琴：然後還是要跟主席抗議一下，因為前面可以講到20分鐘。以上，謝謝。"],["邱部長泰源：謝謝。"],["主席：他超過4分鐘，你也超過4分鐘。謝謝林委員、謝謝部長。","接續請陳菁徽委員質詢。"]],"agenda":{"page_end":314,"meet_id":"委員會-11-3-26-2","speakers":["蘇清泉","陳昭姿","林月琴","陳菁徽","王育敏","邱鎮軍","廖偉翔","涂權吉","黃秀芳","王正旭","林淑芬","羅智強","黃國昌","楊瓊瓔","陳瑩","洪孟楷","張啓楷","劉建國","陳培瑜","楊曜","王義川"],"page_start":227,"meetingDate":["2025-03-13"],"gazette_id":"1142701","agenda_lcidc_ids":["1142701_00006"],"meet_name":"立法院第11屆第3會期社會福利及衛生環境委員會第2次全體委員會議紀錄","content":"邀請衛生福利部部長就「有關全國急重症醫療量能」進行專題報告，並備質詢","agenda_id":"1142701_00005"}}}