{"error":false,"id":["167310"],"data":{"IVOD_ID":167310,"IVOD_URL":"https://ivod.ly.gov.tw/Play/Clip/1M/167310","日期":"2026-01-29","會議資料":{"會議代碼":"委員會-11-4-26-22","會議代碼:str":"第11屆第4會期社會福利及衛生環境委員會第22次全體委員會議","屆":11,"會期":4,"會次":22,"臨時會會次":null,"種類":"委員會","委員會代碼":[26],"委員會代碼:str":["社會福利及衛生環境委員會"],"標題":"第11屆第4會期社會福利及衛生環境委員會第22次全體委員會議"},"影片種類":"Clip","開始時間":"2026-01-29T09:53:22+08:00","結束時間":"2026-01-29T10:08:31+08:00","影片長度":"00:15:09","支援功能":["ai-transcript"],"video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/58229044bac95a88a79b5f0d78716b2d52fd623850d83d5b9da39f225449bb57dc3fb96d4c95e3195ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"陳菁徽","委員發言時間":"09:53:22 - 10:08:31","會議時間":"2026-01-29T09:00:00+08:00","會議名稱":"立法院第11屆第4會期社會福利及衛生環境委員會第22次全體委員會議（事由：邀請衛生福利部就「春節急診醫療人力調度與跨院協調機制之現況與精進作為」暨「假日及連續假期急重症分級醫療政策之執行成效與改進方向」進行專題報告，並備質詢。\n\n討論事項\n審查\n一、 委員何欣純等17人擬具「國民年金法第五十四條之一及第五十五條條文修正草案」案。\n二、 委員邱鎮軍等17人擬具「國民年金法第十五條及第五十四條之一條文修正草案」案。\n三、 委員王美惠等18人擬具「國民年金法第五十四條之一條文修正草案」案。\n四、 委員劉建國等16人擬具「國民年金法第五十四條之一條文修正草案」案。\n五、 委員馬文君等20人擬具「國民年金法第五十四條之一條文修正草案」案。\n六、 委員徐巧芯等18人擬具「國民年金法第五十四條之一條文修正草案」案。\n七、 台灣民眾黨黨團擬具「國民年金法第五十四條之一條文修正草案」案。\n八、 委員邱鎮軍等21人擬具「國民年金法第十五條及第五十條條文修正草案」案。\n九、 委員陳俊宇等29人擬具「國民年金法第五十四條之一條文修正草案」案。\n十、 台灣民眾黨黨團擬具「國民年金法第十五條及第五十條條文修正草案」案。\n十一、 委員黃秀芳等21人擬具「國民年金法第五十四條之一條文修正草案」案。\n十二、 委員羅廷瑋等16人擬具「國民年金法第五十四條之一條文修正草案」案。\n十三、 民進黨黨團擬具「國民年金法部分條文修正草案」案。\n十四、 委員蔡易餘等17人擬具「國民年金法部分條文修正草案」案。\n十五、 委員吳思瑤等18人擬具「國民年金法部分條文修正草案」案。\n十六、 委員郭國文等17人擬具「國民年金法第五十四條之一條文修正草案」案。\n十七、 委員王美惠等22人擬具「國民年金法部分條文修正草案」案。\n十八、 委員徐富癸等18人擬具「國民年金法第五十四條之一條文修正草案」案。\n十九、 委員陳亭妃等16人擬具「國民年金法部分條文修正草案」案。\n【專題報告與討論事項綜合詢答，討論事項僅詢答】）","transcript":{"pyannote":[{"speaker":"SPEAKER_00","start":0.14909375000000002,"end":3.03471875},{"speaker":"SPEAKER_00","start":3.18659375,"end":3.6253437500000003},{"speaker":"SPEAKER_02","start":5.14409375,"end":6.443468750000001},{"speaker":"SPEAKER_02","start":8.755343750000002,"end":9.430343750000002},{"speaker":"SPEAKER_00","start":10.341593750000001,"end":20.80409375},{"speaker":"SPEAKER_00","start":21.15846875,"end":24.95534375},{"speaker":"SPEAKER_00","start":25.10721875,"end":32.39721875},{"speaker":"SPEAKER_01","start":27.16596875,"end":27.65534375},{"speaker":"SPEAKER_01","start":32.19471875,"end":32.58284375},{"speaker":"SPEAKER_00","start":32.51534375,"end":55.212218750000005},{"speaker":"SPEAKER_01","start":34.658468750000004,"end":34.94534375},{"speaker":"SPEAKER_02","start":55.549718750000004,"end":69.65721875},{"speaker":"SPEAKER_00","start":68.45909375000001,"end":70.50096875},{"speaker":"SPEAKER_00","start":71.09159375,"end":72.00284375000001},{"speaker":"SPEAKER_02","start":72.40784375,"end":75.52971875},{"speaker":"SPEAKER_00","start":74.31471875000001,"end":74.80409375},{"speaker":"SPEAKER_00","start":75.02346875,"end":129.93471875},{"speaker":"SPEAKER_02","start":130.13721875000002,"end":158.95971875},{"speaker":"SPEAKER_00","start":155.71971875,"end":155.78721875000002},{"speaker":"SPEAKER_02","start":159.49971875,"end":172.51034375},{"speaker":"SPEAKER_00","start":170.13096875000002,"end":174.31596875000002},{"speaker":"SPEAKER_02","start":173.18534375000002,"end":174.21471875},{"speaker":"SPEAKER_02","start":174.97409375,"end":178.04534375},{"speaker":"SPEAKER_00","start":176.99909375000001,"end":177.60659375},{"speaker":"SPEAKER_00","start":178.11284375000002,"end":195.17346875},{"speaker":"SPEAKER_00","start":196.10159375,"end":225.75096875000003},{"speaker":"SPEAKER_00","start":225.97034375,"end":227.60721875000002},{"speaker":"SPEAKER_00","start":228.31596875000002,"end":241.02284375000002},{"speaker":"SPEAKER_02","start":238.17096875000001,"end":238.23846875},{"speaker":"SPEAKER_02","start":241.02284375000002,"end":305.29971875},{"speaker":"SPEAKER_01","start":285.01596875,"end":287.96909375},{"speaker":"SPEAKER_00","start":287.96909375,"end":288.96471875000003},{"speaker":"SPEAKER_01","start":288.96471875000003,"end":289.09971875},{"speaker":"SPEAKER_00","start":305.14784375,"end":313.97346875},{"speaker":"SPEAKER_02","start":307.56096875000003,"end":307.98284375000003},{"speaker":"SPEAKER_02","start":308.42159375,"end":310.71659375},{"speaker":"SPEAKER_02","start":311.77971875000003,"end":342.77909375},{"speaker":"SPEAKER_00","start":342.77909375,"end":375.83721875000003},{"speaker":"SPEAKER_02","start":376.14096875,"end":408.84471875},{"speaker":"SPEAKER_01","start":399.07409375000003,"end":399.49596875000003},{"speaker":"SPEAKER_00","start":408.94596875,"end":411.10596875000005},{"speaker":"SPEAKER_00","start":411.20721875000004,"end":415.18971875000005},{"speaker":"SPEAKER_02","start":414.76784375000005,"end":414.78471875},{"speaker":"SPEAKER_01","start":414.78471875,"end":414.90284375000005},{"speaker":"SPEAKER_02","start":414.90284375000005,"end":414.97034375000004},{"speaker":"SPEAKER_01","start":414.97034375000004,"end":415.03784375000004},{"speaker":"SPEAKER_02","start":415.03784375000004,"end":415.34159375},{"speaker":"SPEAKER_00","start":415.30784375,"end":421.85534375000003},{"speaker":"SPEAKER_01","start":415.34159375,"end":415.45971875000004},{"speaker":"SPEAKER_02","start":416.94471875000005,"end":416.96159375},{"speaker":"SPEAKER_01","start":416.96159375,"end":417.02909375},{"speaker":"SPEAKER_02","start":417.02909375,"end":417.36659375000005},{"speaker":"SPEAKER_01","start":417.36659375000005,"end":417.38346875},{"speaker":"SPEAKER_02","start":417.38346875,"end":417.46784375000004},{"speaker":"SPEAKER_02","start":421.99034375,"end":427.03596875000005},{"speaker":"SPEAKER_00","start":423.84659375,"end":435.64221875000004},{"speaker":"SPEAKER_02","start":428.43659375000004,"end":429.02721875000003},{"speaker":"SPEAKER_01","start":429.02721875000003,"end":430.49534375},{"speaker":"SPEAKER_01","start":435.33846875,"end":435.99659375000005},{"speaker":"SPEAKER_00","start":435.77721875000003,"end":439.28721875},{"speaker":"SPEAKER_01","start":439.13534375,"end":439.45596875},{"speaker":"SPEAKER_00","start":439.42221875,"end":449.37846875},{"speaker":"SPEAKER_01","start":444.61971875,"end":444.92346875000004},{"speaker":"SPEAKER_00","start":449.41221875,"end":449.44596875},{"speaker":"SPEAKER_02","start":449.44596875,"end":451.01534375000006},{"speaker":"SPEAKER_00","start":449.47971875,"end":450.15471875000003},{"speaker":"SPEAKER_00","start":450.71159375,"end":455.41971875},{"speaker":"SPEAKER_02","start":454.93034375,"end":460.14471875000004},{"speaker":"SPEAKER_00","start":458.17034375000003,"end":458.40659375},{"speaker":"SPEAKER_00","start":459.63846875,"end":465.44346875},{"speaker":"SPEAKER_02","start"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部長請時部長陳委員早今天我們會拍這個專報就是因為我們怕去年經歷的春節擁捨急診擁捨這樣子的現象今年重蹈覆轍其實很多醫務人員也在也在擔憂啦那這個是去年我不知道印象很深刻去年呢發生了急診擁捨之後賴總統"},{"start":29.003,"end":54.918,"text":"當時有親自主持健康台灣推動委員會那他就說他非常關切這件事情那我們看衛福部自己發的文他寫得很清楚總統當時下令要落實分級並且呢總統指示說要建立一個民眾版的就醫指引那賴總統的支票已經開一年了這個傳說中可以解決傭色的民眾版就醫指引你們弄好了嗎"},{"start":55.959,"end":70.115,"text":"跟委員說明這個指引的部分那個144現在已經到了最後因為他要跟很多醫學會討論那差不多了那麼應該看看能不能在下個月初我們就會先上網下個月初"},{"start":71.164,"end":89.785,"text":"春節前我們就會讓他先上我給你看一下這個是我查到的因為你們蠻重視這件事嘛那我就上你們的網站去查你們的就醫指引到底在哪裡結果這個就醫指引是10年前的檔案這個你自己也知道啦"},{"start":91.167,"end":107.203,"text":"他是105年上傳的並且他上傳的檔案裡面還有提到行政院衛生署行政院衛生署是2013年改制的表示他上傳這個檔案有可能這個檔案還更早比2015年還更早那我把這邊全部都讀完了52頁"},{"start":109.725,"end":129.634,"text":"總統說到的分級醫療隻字未提裡面有講到說你去看醫生的時候你要自己怎麼樣整理自己的病情然後你應該跟醫生講什麼他有講到這些可是對於這個分級他是沒有講到那現在很開心聽到你說你要修改請問你修改的重點可以簡單一兩分鐘跟我們講一下就好了嗎"},{"start":130.174,"end":158.293,"text":"但他的這個重點上最重要是讓民眾清楚什麼時候到急診什麼時候其實在這個就近的這個基層診所看就可以重點在這個地方判斷這個需要去緊急就醫的那個要件是哪一些那我們也會搭配這個開診的資訊好像春節期間的我們都目前持續在調查當中那麼在1月28號我們健保已經在這個我們的那個"},{"start":160.292,"end":177.467,"text":"就醫資訊上面有個專區春節的就醫資訊專區裡面會列出所有每一天有開診的診所在哪一個區就可以查詢你會提供一個PDF檔會有一個APP就可以查"},{"start":178.528,"end":193.139,"text":"剛講了這麼多我們來看一下這個表這個是我剛上任的時候做過的總質詢當時的行政院長還是陳建仁我說蔡英文總統執政8年分級醫療是不動如山並且花了總共530億元所以她"},{"start":196.121,"end":213.812,"text":"民眾到醫學中心就醫的比例從106年到112年都是10點多%你們是把106年設定成一個基期那我們就從賴總統上任以來 我們來分析112到113又上漲了1% 10到11.8113到114又變成11.8到12.19"},{"start":220.936,"end":249.978,"text":"我也想問因為當時我在做這個質詢的時候您是署長不知道有沒有印象那這個這三年這兩三年的投入看起來是出了什麼問題因為你的預算跟政策看起來是無效甚至是更加惡化到底問題在哪裡之前還是持平現在是一年上升一趴跟委員報告因為這樣的數字太過於RAF我們有更細緻的去分析我們的做法上是把"},{"start":250.679,"end":255.001,"text":"醫院裡面把門診扣除掉重大傷病"},{"start":255.444,"end":284.706,"text":"扣除掉門診手術扣除掉急診因為我們在申報的時候會急門診是一起的把它扣除之後去看它的占比在醫學中心的平均占比這樣所謂的輕症占比是38%整個醫院收入的38%那麼到區醫院的等級的話呢它是大概50到55%到地區醫院是65%所以以這樣來看我們的分級醫療是成功的"},{"start":285.046,"end":300.354,"text":"你是用他的點子全部加起來他看的病人就是比較重就是說他很高的比例是重大傷病者那些癌症的病人這些你是需要到醫學中心就應該到醫學中心這個是OK的"},{"start":300.814,"end":328.452,"text":"所以按照这样来看这个数字的占比医学中心是在下降那你什么时候会提出你的新的评估表因为你应该要提出一个新的评估表嘛你要怎么样看哪些指标分别要可以落实有那因为我们就搭配了个别医院总统在看这个事情我想委员也听我讲过需要降到50%以下因为有的医学中心我刚刚讲的是平均是38%可是有的医院是高的所以要"},{"start":329.252,"end":343.7,"text":"超過50%的一定要降到50%以下我們會透過這個健保的機制醫院個別總和來調整所以來導引讓這個各層級的醫院扮演他的角色好 這個是你講的"},{"start":344.52,"end":359.919,"text":"你說你會先觀察你去年10月的時候說先進入一個觀察期然後再來醫院聯盟再來是漲部分負擔但是我們從過去這段時間來看你有漲過但似乎沒有什麼太大的效果目前我們面臨的困難是對基層"},{"start":361.701,"end":383.216,"text":"信任嘛因為大家可能覺得他平常非常習慣於到這邊看慢性病到醫學中心等等的他現在沒有辦法對基層信任我想知道你從10月到現在你說是觀察期你目前觀察到什麼跟委員說明我們另外再看基層剛剛我提到的是各層級醫院的分級醫療的角色我們認為他是有達到了"},{"start":385.017,"end":408.671,"text":"那麼部分的醫院沒有達到我們會透過個別醫院總額的調整機制那麼來要求至於在基層的部分我們看到在慢性處方間的領取率在基層的部分是提高了所以這個基層我們看到的這個趨勢是有增加的所以我們覺得這個分級效還是它的成效但是可以繼續再往前走"},{"start":408.991,"end":435.006,"text":"那我可以一個月跟你要你說你想設定新的評估數據嗎因為剛剛那個表也是你們自己做的然後做出來的表問你你又說不是這樣子算的可是這表是你做的我們不斷的在精進那一個月可以跟你說那一個月可以要你那新的指標嗎你新的指標那這邊再給你一些具體的建議因為你剛剛自己也講到說你要運用AI嘛"},{"start":435.486,"end":444.651,"text":"好 那其實我們現在就有一個APP健保快力通的APP你為什麼 你剛剛講了 你說你現在在調查春節會開的診所 基層診所然後你可能會給他誘因 對嗎你現在已經在調查了嘛對 誘因已經發布了然後到時候呢 到時候你會做一個檔案然後讓全國的民眾就知道不是只有檔案 它是很優化的查詢它可以根據你的所在地去查"},{"start":460.959,"end":484.171,"text":"我是建議你乾脆把它融入一個看診的地圖有有有 這已經有了我的意思是說你平常可以落實的話你春節就更可以落實更何況春節的時候很多人是在移動中所以他換到另外一個城市可能已經不是他在工作的地方所習慣的基層醫療診所他必須要重新去尋找"},{"start":485.191,"end":499.403,"text":"其實委員你可能沒有下載我們的這個健保的快易通啦我們的健保快易通有啦那個打開打開喔我的意思是說我的意思是說你要把它融入節日的時候有開的"},{"start":501.745,"end":505.929,"text":"你知道我的意思嗎因為我們現在就是在談論春節擁捨的問題那你平常當然一到五我自己打開我去查我去計程車所很ok因為這邊是習慣你居住或是工作的地方可是你春節的時候就在移動了那你剛剛很辛苦收集到這麼多的資訊你不是應該要把它融入嗎"},{"start":524.664,"end":549.191,"text":"那包括當然如果可以的話比如說清明連假或者是228連假你可以從這三四天五天的這些連假去做測試嘛因為春節就是一個一整年的壓力測試你如果等到一整年才測試一次我覺得這個就有點久所以平常有些連假的時候你就可以測試我們春節的部分這一次會先"},{"start":550.271,"end":558.637,"text":"拉出專區啦剛剛跟委員說明那個是尋常的拉出那個專區未來我們把假日也用個專區啦你的意思是我的意思就是說其實他什麼時候很需要是因為他可能連假的時候有移動他更不熟悉那附近的基層診所在哪裡或者是誰有開嘛那你也可以鼓勵這些你給他誘因你鼓勵他上傳然後你把他結合進去你的地圖以後那這些他就更有誘因他可以被查詢到"},{"start":581.172,"end":596.5,"text":"好那第二個就是這個UCC但是我剛好聽其他委員質詢所以我可能再等待一段時間聽起來你現在還沒有辦法給我們一個UCC你有沒有要擴大還是沒有要擴大是嗎對我們當時候就提到說16個月之後會檢討那來決定調整或擴大好"},{"start":600.442,"end":619.107,"text":"那十六個月之後我們再來跟你查詢這個那第二個問題因為這個也是急診室擁捨最近就是剛好是近期靠近春節的前後都會發生的因為我們現在有很多的尾牙春酒然後還有春節這個過年大家去餐廳吃飯等等的那2024年醫療暴力高達444件是五年來的新高近六成都在急診室"},{"start":629.01,"end":647.302,"text":"因為這樣子私人的活動所引起的醫療需求也就是說喝太多通常送到急診他就打點滴這個你都很清楚因為你也是急診科醫生睡覺可是他其實消耗掉非常多醫護的量能對這個你都懂那包括我們的警察救護車等等"},{"start":648.143,"end":663.434,"text":"那這個是你們次長自己講的 你們次長說他開始想到一些研議的方法比如說參考其他國家 瑞士啊 美國啊會有一個禁制隔離式 類似讓他行久的這種觀察式他不一定是醫療機構裡面 或者是醫療人員來成立的那他講了這個話 後來又有新聞 請問你們內部有開過會嗎"},{"start":672.823,"end":691.406,"text":"這個跟委員說明過去在急診經常會處理這一種病那麼一般來講有兩種狀況一種是因為他的混亂讓我們無法判斷他有沒有醫療問題他可能同時有外傷或什麼可是又有酒精的效果那一種才需要在醫院裡面留"},{"start":691.766,"end":696.328,"text":"那是我純粹是要睡覺的不准在醫院睡覺這個我等一下會跟你討論我的意思是說你們次長講了這個然後這個也上了新聞你們到底有沒有要研擬我不是在問你急診處理的guideline"},{"start":706.99,"end":725.202,"text":"這個所謂的靜置區齁這個靜置區就是觀察區啦就是觀察啦啊只是讓他不要去干擾到醫護人員或者是其他他就是個觀察區不是睡覺區啦就是說他有醫療的需要那需要留觀的時候讓他有一個isolate的地方我們會來研議因為過去齁在有一些醫院的急診有這種這個譬如說AQpsychotic的病人他就會"},{"start":735.922,"end":760.007,"text":"就會在這一個房間裡面去靜置不見得是酗酒所以聽起來你是想把它放在醫院裡面有時候是需要的聽起來你是希望把它放在醫療院所裡面不是不是不是不是我剛剛提到的是有一些急性精神病人他會有混亂的情形也會在急診裡面有一個獨立的空間對啊那就是醫療院所裡面就一樣啊就是跟這個概念是一樣"},{"start":760.387,"end":789.449,"text":"我剛剛提到的是喝酒醉的喝酒醉的要睡覺就回家睡覺不是在醫院裡面擺一個空間給他酒醒沒有這回事情但是他如果有醫療的需要需要觀察看看他有沒有其他的問題因為有時候酒精的會影響到在病人病情診斷跟處事上的影響需要觀察那就留在這裡我先幫你整理我先幫你整理一下就是其實最近也有一個新聞"},{"start":790.329,"end":815.509,"text":"這個新聞是他其實常常是想要回家但是他在回家的路上因為交通事故發生問題所以也不是這麼簡單但你們次長所講出來的整理了世界各國比如說瑞士、美國、加拿大、澳洲他們都有做類似這樣子的行酒中心他們可能是地方政府或者是非營利機構做主要就是做幾個事情當然他會去判斷他需不需要去醫院就像你剛剛講的他現在沒有急症嘛呼吸抑制"},{"start":816.369,"end":824.932,"text":"嚴重的嘔吐或是意識喪失這個是他要判斷的如果沒有不需要醫療介入的可以自然等待清醒的會放在這邊安全的去安置監測離開的時候是要付費的那離開之後他可能還會被記錄如果他很常來"},{"start":832.554,"end":851.061,"text":"他可能要過濾出有酒飲的人需要去戒斷的人還要去上課的人等等的但是他在其他國家很多並不一定是由醫療機構來做因為他很多處置並不需要醫療人員所以這個就是一個月內希望可以要到你"},{"start":852.361,"end":871.352,"text":"研擬之後評估之後你到底多久要達成因為這個也是解決我們春節擁捨的其中一個小的項目或是平常跟委員報告這個一個月沒有辦法這個要跨部會不可能把它放在醫院裡面那我們多久可以再跟你討論"},{"start":872.333,"end":899.611,"text":"三個月啦 我們來研究看看好啊 三個月那裡面就這幾個重點就請您稍微看一下就主觀的去判斷就這個到底機構法源基礎在哪裡它是醫療的還是警政還是民政嘛然後它的比如說你們要不要收費那它是不是會跟一些戒癮來做串聯那主觀的判斷是要送醫院還是留在這邊等等然後各國遇到預算問題社區的接受度等等好 那我們就三個月可以再跟您討論好 謝謝"},{"start":904.997,"end":908.502,"text":"好 謝謝陳勤輝委員發言接下來請王育民委員發言"}]}},"supported_relations":[],"relations":[]}