{"error":false,"id":["167314"],"data":{"IVOD_ID":167314,"IVOD_URL":"https://ivod.ly.gov.tw/Play/Clip/1M/167314","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":"2026-01-29T10:18:48+08:00","結束時間":"2026-01-29T10:30:00+08:00","影片長度":"00:11:12","支援功能":["ai-transcript"],"video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/58229044bac95a88796b3c71fa483f4652fd623850d83d5b9da39f225449bb572cfcc21c557743ff5ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"邱鎮軍","委員發言時間":"10:18:48 - 10:30:00","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_01","start":0.84096875,"end":3.57471875},{"speaker":"SPEAKER_01","start":4.77284375,"end":42.471593750000004},{"speaker":"SPEAKER_00","start":14.99909375,"end":15.336593750000002},{"speaker":"SPEAKER_00","start":18.20534375,"end":18.610343750000002},{"speaker":"SPEAKER_00","start":33.88221875,"end":34.00034375},{"speaker":"SPEAKER_01","start":42.893468750000004,"end":46.977218750000006},{"speaker":"SPEAKER_00","start":47.399093750000006,"end":52.680968750000005},{"speaker":"SPEAKER_00","start":53.001593750000005,"end":71.85096875},{"speaker":"SPEAKER_01","start":57.203468750000006,"end":58.72221875},{"speaker":"SPEAKER_01","start":71.85096875,"end":78.88784375},{"speaker":"SPEAKER_00","start":73.99409375,"end":75.63096875000001},{"speaker":"SPEAKER_00","start":78.88784375,"end":91.93221875},{"speaker":"SPEAKER_00","start":92.59034375,"end":104.57159375},{"speaker":"SPEAKER_01","start":92.70846875000001,"end":92.91096875000001},{"speaker":"SPEAKER_01","start":94.04159375,"end":94.73346875},{"speaker":"SPEAKER_01","start":97.23096875,"end":98.02409375},{"speaker":"SPEAKER_01","start":101.17971875,"end":103.27221875000001},{"speaker":"SPEAKER_01","start":104.60534375,"end":106.34346875},{"speaker":"SPEAKER_01","start":106.74846875,"end":115.18596875},{"speaker":"SPEAKER_00","start":109.27971875,"end":109.73534375000001},{"speaker":"SPEAKER_00","start":115.27034375000001,"end":130.25534375},{"speaker":"SPEAKER_01","start":116.29971875000001,"end":116.41784375},{"speaker":"SPEAKER_01","start":128.55096875,"end":174.34971875000002},{"speaker":"SPEAKER_00","start":134.23784375,"end":134.30534375000002},{"speaker":"SPEAKER_00","start":136.81971875000002,"end":137.24159375000002},{"speaker":"SPEAKER_00","start":156.64784375000002,"end":156.96846875},{"speaker":"SPEAKER_00","start":168.88221875000002,"end":169.23659375},{"speaker":"SPEAKER_01","start":174.78846875000002,"end":175.42971875},{"speaker":"SPEAKER_00","start":175.46346875,"end":203.20596875},{"speaker":"SPEAKER_01","start":196.75971875000002,"end":198.51471875000001},{"speaker":"SPEAKER_01","start":201.85596875000002,"end":201.87284375000002},{"speaker":"SPEAKER_01","start":201.88971875000001,"end":207.40784375},{"speaker":"SPEAKER_00","start":205.66971875000002,"end":205.78784375},{"speaker":"SPEAKER_00","start":205.87221875,"end":218.42721875},{"speaker":"SPEAKER_01","start":217.92096875000001,"end":229.54784375000003},{"speaker":"SPEAKER_00","start":218.96721875,"end":220.18221875},{"speaker":"SPEAKER_00","start":223.20284375000003,"end":223.37159375000002},{"speaker":"SPEAKER_00","start":227.43846875000003,"end":227.50596875000002},{"speaker":"SPEAKER_00","start":228.70409375000003,"end":232.99034375000002},{"speaker":"SPEAKER_01","start":230.27346875,"end":235.06596875000002},{"speaker":"SPEAKER_00","start":233.20971875,"end":234.07034375},{"speaker":"SPEAKER_01","start":235.15034375000002,"end":236.48346875000001},{"speaker":"SPEAKER_01","start":236.73659375000003,"end":237.34409375},{"speaker":"SPEAKER_01","start":238.30596875,"end":239.11596875},{"speaker":"SPEAKER_01","start":239.40284375000002,"end":250.62471875000003},{"speaker":"SPEAKER_00","start":244.31346875000003,"end":244.70159375000003},{"speaker":"SPEAKER_00","start":246.67596875,"end":246.86159375000003},{"speaker":"SPEAKER_00","start":250.87784375,"end":253.32471875000002},{"speaker":"SPEAKER_01","start":253.32471875000002,"end":253.34159375000002},{"speaker":"SPEAKER_01","start":253.71284375000002,"end":258.74159375},{"speaker":"SPEAKER_00","start":254.10096875000002,"end":255.40034375000002},{"speaker":"SPEAKER_00","start":259.97346875,"end":269.59221875000003},{"speaker":"SPEAKER_00","start":269.87909375000004,"end":269.89596875},{"speaker":"SPEAKER_01","start":269.89596875,"end":282.65346875},{"speaker":"SPEAKER_00","start":282.80534375,"end":284.47596875},{"speaker":"SPEAKER_01","start":283.05846875000003,"end":284.52659375},{"speaker":"SPEAKER_00","start":284.52659375,"end":293.80784375},{"speaker":"SPEAKER_01","start":292.03596875,"end":313.66971875},{"speaker":"SPEAKER_00","start":295.57971875000004,"end":299.41034375000004},{"speaker":"SPEAKER_00","start":300.40596875,"end":301.08096875},{"speaker":"SPEAKER_00","start":314.10846875000004,"end":321.04409375},{"speaker":"SPEAKER_01","start":320.82471875000005,"end":321.24659375000005},{"speaker":"SPEAKER_00","start":321.24659375000005,"end":333.76784375},{"speaker":"SPEAKER_01","start":333.76784375,"end":376.95096875},{"speaker":"SPEAKER_00","start":341.27721875000003,"end":341.31096875000003},{"speaker":"SPEAKER_00","start":348.82034375,"end":349.15784375000004},{"speaker":"SPEAKER_00","start":378.33471875000004,"end":379.31346875},{"speaker":"SPEAKER_00","start":379.38096875,"end":387.68346875000003},{"speaker":"SPEAKER_01","start":385.30409375000005,"end":399.02346875},{"speaker":"SPEAKER_00","start":388.18971875,"end":388.5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謝謝主席 我們請部長要請石部長好 最後一人早部長好剛剛大家都在關心這個議題就是我們春節期間那我看了一下資料這個去年的時候平均每天急診就3.7萬人次那最高單日達到4.5萬人"},{"start":21.696,"end":46.81,"text":"不論對急診醫護人員或對正在等床等救命的病人來說都是一個非常緊繃甚至帶有風險的一個狀況尤其是對重症的重症者而言時間就是生命那部長你們所謂的強化區域聯防機制遇到某一家醫院或某一個區域急診跟ICU的量能已經飽和的時候實際負責調度跟轉送決策的是誰是中央還是地方"},{"start":48.275,"end":74.102,"text":"這個當然是這個跟委員報告說我們第一個是監測系統把它建立起來所以包含這個ICU 膠物病房的量的情形都有然後地區上我們有一個這個地區的這個RMEOC這個區域的緊急醫療應變中心會協助衛生局來做病床的所以他是中央來主導還是地方在掌控"},{"start":76.463,"end":91.321,"text":"地方失靈的時候我們中央什麼時候會介入因為我們也建立了這個平台所以我們會他需要跨區的協助的時候我們就會透過這個剛剛提到的REMOC來協助跨區的調度這樣"},{"start":93.085,"end":113.503,"text":"您提的是這樣因為每個縣市衛生局他只能管到他轄內醫療院所那可能每一個縣市的醫療資源因為我看到有這個需要跨區的調度有這個東西但是就是沒有人負責我現在意思是這樣總是要有一個人負責去做這件事情不能說到時候出了狀況又推來推去的"},{"start":116.005,"end":139.57,"text":"會 今年我們特別強化這個區域的合作包含我們的這個健保的分區業務組的組長包含我們這個剛剛提到的這個REMOC都會在這個對啦 我不希望這只是林委員寫得很清楚我希望這個還是要有一個人負責這樣才有責任當然這樣做起來才會比較有效率 好吧那另外我看到你們這個春節的整備專案裡面"},{"start":140.51,"end":163.391,"text":"你們投入了16億用在診察費跟護理費跟藥事服務費加成簡單說這16億其實有兩個目標啦當然是一個降低急診擁塞的情況嘛那第二個是安撫我們在線的這個第一線比較忙碌的這些人員嘛那我們先講第一個目標你們要避免春節急診擁塞核心的做法就是讓"},{"start":164.452,"end":174.53,"text":"醫院門診 急診診所願意開診讓輕症患者有地方去嘛那不要全部都擠到急診去那你有沒有設定一個目標你們這一次要打到幾層啊"},{"start":175.578,"end":204.119,"text":"就是說在醫院的部分過去大概開診率比較低的都是初一、初二、初三一般都初四、初五就開診了所以我們去提高初一、初二、初三這幾天的開診率那目前看起來醫院都會到七成以上都會開了那另外基層的部分過去這幾天大概都2%到4%左右而已那我們今年希望能夠提高到大概10%左右你怎麼做 你這個時日你要怎麼做"},{"start":205.4,"end":230.567,"text":"怎麼做讓他我們現在已經第一個我們有這個剛剛提到的這個獎勵的機制另外有衛生局可以協調地方的醫師公會去這個安排看診然後我們再把這個已經有具體做了嗎已經在進行了我不希望這只是這個花了錢在碰運氣啦不要說我有這個政策但是呢要看這個地方的診所自己願意參加我們提供獎勵當然要進去協調啦我覺得這個才會有效果"},{"start":234.028,"end":258.471,"text":"因為再來就是我們這個疾管署我們2025年春節期間全國加開的傳染病特別門診大概是1230次這個診症那今年延續去年一樣會開今年要開多少次一樣就是急救責任醫院都會開因為你們去年好像只有提高一成嘛對不對"},{"start":260.712,"end":269.325,"text":"對 去年只有CDC的流感門診有獎勵措施今年是全面性的 有健保介入"},{"start":270.768,"end":291.805,"text":"那第二個目標就是我們讓這個春節要上班急診與住院的這個病房醫師醫護人員在原本的加班費之外再有額外的補償加成嗎這樣沒有錯嗎對就是我們提供的提供在這個住院的部分的這個護理費、診察費還有這個藥事服務費都加成"},{"start":292.245,"end":313.273,"text":"我看到你們的規定寫得非常明確,至少有80%要實際發給出行的人員那我看到因為醫學中心違例,一名護理人員在春節期間只要實際上一個班在這個加成制度下,實際可以領多少錢?有算過嗎?"},{"start":314.298,"end":333.6,"text":"沒有 這個是我們以這樣的方式去給醫院費用但是醫院還要去分攤給其他的比如說他可能也有清潔人員要出來或者是S光 醫師檢驗師 醫師放射師所以他們是要去這個錢去給有上班的人大家去分配的"},{"start":333.84,"end":347.441,"text":"那個護理師公會全國聯合會在社群上有幫你們計算這個做法把它計算出來那以醫學中心急性一般病床為例這個護理費第二天以後是888點"},{"start":349.304,"end":360.969,"text":"春節加成100%每床大概多888點40床就是35520點如果一天三班合計16人出勤平均每人可以分配到2220點那其中至少八成約1776點應該要發給實際出勤的第一線人員一天有三班等於護理師 護理人員上一個班大概多600元左右這個數字對嗎"},{"start":379.717,"end":405.094,"text":"我不太敢確定是醫院怎麼樣去處理這些費用因為他們本來就有在加我知道他實際是給院裡面處理但我現在問的不是個案差異而是制度設計下合理推估上一個班第一線護理人員到底能夠拿到多少這如果我們自己都講不出來這個加成對他們來說到底是不是一個有感的一個獎勵金我覺得部長要去思考"},{"start":405.834,"end":431.996,"text":"好不好 因為這個我覺得非常重要啦 因為我們不曉得他們怎麼去處理嘛 我覺得我們部裡面既然有這個心意我還是要讓醫護人員能夠感受到 好不好另外 我們賴總統在選前親自向護理人員做出明確的承諾開出一張很清楚的支票 三班護病筆要入法 兩年內要入法現在今年五月二十賴總統就要兩年了 上任就要兩年了"},{"start":432.316,"end":441.655,"text":"那目前只剩下半年的時間我請教部長我們總統的政見三班戶並比兩年要入法這項承諾會不會跳票"},{"start":442.911,"end":469.908,"text":"我想這個在這個三班護病比上我們做了很多的努力那現在看起來護理人員有在這個提升這個已經在回流了啦然後這個符合達標的比例也在提高那不過呢我們還有很多的做法包含這個自動化的措施簡化那麼對因為很多醫院所以到底這個護病比應該要做什麼樣的他已經達標了沒有錯有很多已經到地區醫院到92點"},{"start":471.169,"end":471.69,"text":"我想這個互併筆入法"},{"start":492.727,"end":502.723,"text":"這個我想這個方向我們會朝這個方向來努力不過重點是那個比例應該是多少要讓它有彈性不要是一個很固定的一個數值反而那個彈性不見了那麼"},{"start":505.447,"end":525.972,"text":"反而讓這個醫院沒有願意去投入讓他去降低這個臨床的負荷那同時也可能影響到病人的權益啦所以這個我們是要兩邊要兼顧的所以我是覺得這個部分還是要加快因為我們醫護人員這個大出走的時候我們再來處理就太慢了"},{"start":527.32,"end":555.054,"text":"降低這個臨床的負荷這個目標是一致的這個不會改變但是我剛剛提到的這個護病比的數字不要用一個單一的數字我希望這樣啦 這個議題這個法案不要變成一個政治議題啦不要說到時候萬一這個出了狀況之後才拿來做趕快來入法然後來救生量我不希望把它變成一個政治工具好不好部長你這個盡快那另外最近看到新聞啦就是"},{"start":556.455,"end":579.802,"text":"這個印度西孟加拉省爆發的高致死率的立百病毒的疫情那我看到我們的報告就是說預告60天所以在3月中會將立百病毒列為第五類法定傳染病那我們在1月27號發布這個醫界通函提醒醫師詢問這個旅遊史等等這些但我看到看的是說"},{"start":581.082,"end":603.818,"text":"預告期60天是你們的行政慣例那可是其實亞洲國家其實就已經戰戰兢兢在在解決這個事情你不覺得60天太久嗎這個我們隨時來調整不過我們在一介通海裡面已經提到就可以開始通報了那這個預告完之後那個就變成強制性啦那現在我們已經是要求提高這個警覺如果"},{"start":604.659,"end":619.438,"text":"排除了現有的病毒性感染特別是在腦炎的部分尤其現在是春節期間很多國人都會從這個在外面的都會回來或者出國旅遊的所以我覺得這是高峰期你這個我覺得這個東西你拖到60天會不會太慢不會"},{"start":621.04,"end":639.515,"text":"應該跟委員說明這個是法律規定我們就這樣做可是實務上我們在進行的防疫措施已經啟動了那另外也藉這個機會也跟國人說明一下目前在印度發生的這一個立百病毒的案例看起來是控制住的"},{"start":640.155,"end":663.046,"text":"你不要講控制 當初花蓮那個焰射壺也是說控制住 後來不是出了狀況對不對 我覺得我們還是不管做什麼啦 就是說還是要未雨綢繆我希望這個東西就是未雨綢繆我們做好準備 但是國人不需驚慌不用太擔心 當然不用驚慌 可是因為要相信你們啦對不對 對但是我希望布裡面不要讓人民失望沒有問題 謝謝"},{"start":669.834,"end":672.656,"text":"好 謝謝邱正軍委員發言 接下來請"}]}},"supported_relations":[],"relations":[]}