創新性健康管理營運模式服務之研究

Abstract

目前國內的疾病型態已由過去的急性病與傳染病為主，轉型為以慢性病及其併發症為主。過去十年來，癌症、腦血管疾病及心臟疾病等非傳染性的慢性病或其相關併發症，估計和慢性疾病相關的死亡比例已超過六成。傳統的醫療模式是以疾病治療為中心，而此種模式已無法因應新的挑戰，相對的以疾病預防為主軸的預防醫學已經逐漸受到重視。近年來，許多先進國家皆以更積極的「健康管理」來取代「疾病預防」：在疾病未發生或發生早期，投資中等花費的健康行為介入來獲取非常有效的健康回報以及社會成本的下降。 綜觀國內在於疾病預防仍以健康檢查為主，對個人而言，健檢產品是以疾病篩檢為導向發展而來，以早期發現疾病為目的，然以健康管理的眼光來看健康檢查仍屬被動行為。在醫院經營上，自費健檢是為了擺脫健保的諸多限制尋求新的市場，早期因為獲得多數民眾認同而開啟龐大商機，然當越來越多的機構投入後，也漸漸競爭激烈而獲利降低。即使是近年來訴求貴族化、精緻化，大量運用高科技儀器的影像檢查與功能性醫學檢查，也因為眾多競爭者加入而面臨相同的窘境。 有鑑於此，本研究提出「全方位健康管理服務」營運模式，提出健康管理應該是分成四階段的，分別是健康資訊的獲取、健康風險評估、保健指導計畫和健康促進，以資訊系統為網路平台、並以健康管理師為服務核心，做為民眾疾病管理與健康促進的重要角色。此外，醫療機構有效整合中西醫服務，以西醫的科學為基礎輔以中醫的養生觀念，並強調身、心、靈的全面評估與介入，讓健檢從消極的「疾病篩檢」，轉化為積極的「健康管理」，不論是疾病治療或是各種健康促進的計劃執行都能提供全面性的整合服務。

The main types of diseases in Taiwan transfer from acute diseases and infectious diseases to chronic diseases and their complications. In the past ten years, the mortality rate of non-infectious disease such as cancer, cerebro-vascular disease and heart disease, as well as its complications, is more than sixty percent of the whole mortality rate. The traditional medical model that focuses on disease treatment is not adequate to respond to the new challenge; on the contrary the preventive medicine which concentrates upon prevention of disease is getting more attention nowadays. In many developed countries, the idea of “Health Management” has replaced “Disease Prevention” in the past few years, which means, in the stage of non-disease or the earlier stages of disease, to make a moderate investment in the intervene of health behavior in order to receive an effective health reward and moreover a decrease in social costs. Overall, the mean of disease prevention is mainly health check-up. From the perspective of health management however such disease-orientated check-up which aim to early discover the disease, is still too passive. The self-paid health check-up was developed by hospitals as a new market to stride across the limitation of health insurance, and indeed brought in a good profit because people were willing to check up their health conditions. But when there are more hospitals joining this market, the profits decrease due to the keen competition. Such plight happens even in the recently-developed high-class check up, image studies and functional medicine assessment that apply high tech instruments. In view of the facts, this study is proposing a business model of the comprehensive health management service, which is composed of four stages, e.g. (a) the acquirement of health information; (b) the assessment of health risk; (c) the directive scheme of health care; (d) the achievement of health promotion. Furthermore, the service model has an information system as a platform and the health managers as the core of service, both of which are essential roles of disease management and health promotion for people. In addition, the medical institution in such model should effectively integrate traditional medicine and modern medicine, using the later as a frame and the former as assistance, emphasizing on an overall intervene of physical and spiritual assessment. The service model transfers health check up from a state of passive “disease discovery” to that of active “health management”, which provide a comprehensive, integrative service of disease treatment and health promotion to people.