以社會創新觀點推動在地醫療網絡： 臺大醫院雲林分院為例

Abstract

衛生福利部(以下簡稱衛福部)自 2021 年 7 月開辦「周產期照護網絡服務計畫」，六都除外，10 個縣市指派代表醫院參加計畫。其中有 3 家醫院申請建制「產科開放醫院模式」，目前預計實施至 2024 年底。 計劃主要包含四大目標：「強化高危險妊娠孕婦產前轉診」、「高危險新生兒外接服務」、「建制產科開放醫院模式」及「產科緊急血庫調度中心」等。前兩項為必備項目，後兩項為選擇項目。計畫開辦以後，臺大醫院雲林分院四項目標均達標，並受衛福部主管機關嘉許。 社會創新概念在 21 世紀受到更多的關注，主旨在於以全新的方式來解決既存的社會問題。本論文引述文獻，說明社會創新的 4 個主要特徵：「新的社會關係」、「互相依存」、「滿足社會需求」及「數位科技導入」。衛福部主導計畫的進行，看出現今基層婦產科醫療院所因少子化之後的服務量能萎縮，甚至退出市場，對於國人婦女懷孕生產過程中，產生的不便性及風險升高，而提出解決方案，立意甚佳。而整個執行的過程中，核心醫院的運作方式，也符合社會創新的概念。 本論文希望由社會創新的觀點來切入我們的社區醫療推展。除了彰顯醫院所提供的照護服務，已不再是純粹的醫療，要借助更多的社會力量融合，必須公部門、私部門、非營利組織、非正式組織，四方共同合作、共同參與，才能使解決問題的方案，可以獲得更多的認同及擴展，提升普及率。 論文中對於可能發生的問題及挑戰，以及管理意涵也做了一些探討。

The Ministry of Health and Welfare initiated the project,「The Service Network for the Perinatal Care in local regions」since July, 2021 and enrolled 10 counties except 6 special municipalities. Three hospitals apply to build up 「new model of obstetric co-care open hospital」. This project will end in December 2024. The main aims of the project including prenatal transfer of high-risk pregnant mothers, quick transfer of distressed newborns, new model of obstetric co-care open hospital and emergent blood transfusion supply modulation. National Taiwan University Hospital Yun-Lin branch completes the 4 aims and encouraged by the Ministry of Health and Welfare for the superior performance. The concept of social innovation got more interest since 21th century. Social innovation refers to innovative activities and services to meet a social need or provide a solution to resolve a pre-existing social problem. Four main characters including new social relationship, trustworthy and accountability between different organizations, meeting social needs and utilizing and promoting by new digital technology. The Ministry of Health and Welfare focuses in the decreasing birth rate in Taiwan and remarkable shrinkage of market in obstetric practices, resulting in withdrawal of obstetricians and future shortage of resource for the better care of pregnant women. The implementation eventually showed a little satisfying outcomes which fulfilling the viewpoint of social innovation. For the more efficient promotion and expansion of the benefits for society, it needs the participations of more social organization and more communications besides. The consolidation of core principles and pragmatic persistence are also needed for successful results.