| IVOD_ID |
159176 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Clip/1M/159176 |
| 日期 |
2025-03-13 |
| 會議資料.會議代碼 |
委員會-11-3-26-2 |
| 會議資料.會議代碼:str |
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 |
| 會議資料.屆 |
11 |
| 會議資料.會期 |
3 |
| 會議資料.會次 |
2 |
| 會議資料.種類 |
委員會 |
| 會議資料.委員會代碼[0] |
26 |
| 會議資料.委員會代碼:str[0] |
社會福利及衛生環境委員會 |
| 會議資料.標題 |
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 |
| 影片種類 |
Clip |
| 開始時間 |
2025-03-13T13:39:55+08:00 |
| 結束時間 |
2025-03-13T13:59:13+08:00 |
| 影片長度 |
00:19:18 |
| 支援功能[0] |
ai-transcript |
| video_url |
https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/3b972b8f6f00770fda5d907b50f204be0aae3c1a04a00b1bb46c869ad093de6af9f7472ed2d1f4185ea18f28b6918d91.mp4/playlist.m3u8 |
| 委員名稱 |
劉建國 |
| 委員發言時間 |
13:39:55 - 13:59:13 |
| 會議時間 |
2025-03-13T09:00:00+08:00 |
| 會議名稱 |
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（事由：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。
【如遇加開院會本次會議取消，不再另行通知】） |
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| transcript.whisperx[0].start |
5.424 |
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9.746 |
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我想今年一月起的流感還有落羅等疾病的流行 |
| transcript.whisperx[1].start |
29.69 |
| transcript.whisperx[1].end |
57.906 |
| transcript.whisperx[1].text |
那全國急診室大爆滿二月更達到這個高峰然後急診醫學會也發文警告急診用篩情況他是講說急診用篩情況已達前所未有的嚴重程度部長當急診醫學會發出這個聲明我是挺感到汗顏也難過因為在你的任內遇到前所未有的急診用篩 |
| transcript.whisperx[2].start |
59.332 |
| transcript.whisperx[2].end |
85.608 |
| transcript.whisperx[2].text |
那部長也貴為醫師雖然是加醫科但也來自台大總統也是醫師我們召委也是醫師蘇召委也是醫師我不是聽到要拖下去所以在你的任內發生這個前所未有的急診用篩的嚴重程度急診醫學會跳出來來訴諸媒體反而不是訴諸我們衛福部相關的單位 |
| transcript.whisperx[3].start |
87.09 |
| transcript.whisperx[3].end |
91.545 |
| transcript.whisperx[3].text |
看如何來做最快的有效的應應的作為來減短這樣的用篩 |
| transcript.whisperx[4].start |
95.481 |
| transcript.whisperx[4].end |
122.306 |
| transcript.whisperx[4].text |
我覺得這是坦白講這是很大的諷刺啦你如果用另外一個高度去思考就是在台灣的醫療尤其是在急診的部分已經很嚴重的問題在發生而且會越來越惡劣啦然後我們都很清楚嘛齁這個廉價的時間過年啊這個過年時間什麼地方人通常關公地窟嘛總告地窟嘛還有一窟你知道嗎便宜啦 |
| transcript.whisperx[5].start |
126.519 |
| transcript.whisperx[5].end |
139.564 |
| transcript.whisperx[5].text |
便衣是絕對是過的時間是可以說弄成十八層、八層的對不對到急診流關的他或許不一定要上到便床但是他可能要在那邊待了三個鐘頭、四個鐘頭、五個鐘頭 |
| transcript.whisperx[6].start |
141.857 |
| transcript.whisperx[6].end |
166.107 |
| transcript.whisperx[6].text |
他會覺得懦弱上吐下瀉他總是要有一個觀察床讓他可以平躺好好休息一下但是基本上是不可能的現在連急診室的那個流光的觀察床都不足甚至是坐在椅子上在等待處置這台灣的急診的狀態部長應該很清楚 |
| transcript.whisperx[7].start |
169.688 |
| transcript.whisperx[7].end |
178.016 |
| transcript.whisperx[7].text |
部長不清楚 醫師師也應該很清楚相關的單位也會很清楚怎麼會變成這個樣子然後讓急診醫學會是透過媒體來發聲我覺得在連結上是出了什麼問題 |
| transcript.whisperx[8].start |
187.194 |
| transcript.whisperx[8].end |
204.981 |
| transcript.whisperx[8].text |
今天如果部長是壓抑還是部長是攝護的我倒不會特別去提醒這個事情就是我用另外一個角度去思考去討論畢竟部長就是我剛剛特別提到你來自台大嘛然後又是加一科的專職這樣的一個專業的醫師總統也是醫師啊那我們怎麼會在這個當下發生這麼嚴重的讓急診醫學會沒有辦法跟你們 |
| transcript.whisperx[9].start |
215.339 |
| transcript.whisperx[9].end |
239.679 |
| transcript.whisperx[9].text |
來做反應 來看如何應應來讓這樣的急診 庸篩不會破紀錄的 前所未有的來得到舒緩我記得這件事情部長要講清楚我也覺得這件事情部長要非常慎重因為等一下會再討論分級醫療分級醫療八年了為什麼做不好你們衛務部連分級的管理都出問題 |
| transcript.whisperx[10].start |
241.755 |
| transcript.whisperx[10].end |
248.497 |
| transcript.whisperx[10].text |
你們衛護部連分級怎麼做都一直出問題啊所以會累死部長今天這件事情如果沒有很慎重的很嚴肅的然後去面對然後而且那個積極的應變的方式趕快出來我覺得我覺得我覺得不要說醫療體系會崩壞基準會崩壞連衛護部你都會崩壞 |
| transcript.whisperx[11].start |
271.567 |
| transcript.whisperx[11].end |
279.033 |
| transcript.whisperx[11].text |
不過你說這個你不知道可以接受嗎我只是恢復之言啦這真的可以在你的臉上發生這件事 |
| transcript.whisperx[12].start |
281.541 |
| transcript.whisperx[12].end |
300.585 |
| transcript.whisperx[12].text |
而且流感、A流、懦弱三種這種很惡劣的這種情況一直在發生你應該都會清楚的醫院會遇到什麼狀況診所會遇到什麼狀況而且又適逢到農曆的過年這其實如果有保護住一段時間或是在病院住一段時間的人就都很清楚了 |
| transcript.whisperx[13].start |
305.168 |
| transcript.whisperx[13].end |
313.049 |
| transcript.whisperx[13].text |
一定有問題要怎麼應變 要怎麼處理你要怎麼想一套應變的方式不要讓這個北方 不要讓這個北方加速不要讓這個醫生 不要讓這個護士三星這麼大這麼大萬年了所以這個萬年都沒有辦法對你們就要透過媒體來跟你們說這真的是我們很大很大的檢討的地方 |
| transcript.whisperx[14].start |
335.213 |
| transcript.whisperx[14].end |
354.12 |
| transcript.whisperx[14].text |
這個不用談到什麼專業了啦 我坦白講啦這種常態的 然後會發生的事情你們連這種常態或發生的事情你們都沒有辦法應變然後今天還有勞蘇昭偉排一個歷史專案報告來這邊做討論的情況之下這幾個人是要怎麼舉的好這家屬是要怎麼奉心喪意去進行 |
| transcript.whisperx[15].start |
360.348 |
| transcript.whisperx[15].end |
385.368 |
| transcript.whisperx[15].text |
這次去診所的醫生要怎麼讓我去救人這次的護士要做到什麼程度 要抄到什麼程度這次能不能遞到你政府 還是便宜了更多的這種事前所未有呢急診用篩情況已達前所未有的嚴重程度你們不敢否認嘛 事實就如此嘛為什麼會這樣呢 |
| transcript.whisperx[16].start |
387.182 |
| transcript.whisperx[16].end |
398.133 |
| transcript.whisperx[16].text |
你們真的面對到問題然後了解到問題怎麼去處理這個問題是不是請部長能用最簡單最快的然後最重點式的方式來做個回應好不好 |
| transcript.whisperx[17].start |
398.735 |
| transcript.whisperx[17].end |
426.348 |
| transcript.whisperx[17].text |
好的 我想我們在在每年過春節的時候我們都很擔心所以就有預備包括政府也幫忙所以我們買了10萬支的一個疫苗希望控制流感然後我們也開健保署也加重了那個各個 尤其是診所給他多30%的一個給付那機關署也在也在那個各個急診 |
| transcript.whisperx[18].start |
428.189 |
| transcript.whisperx[18].end |
449.859 |
| transcript.whisperx[18].text |
補助來成立了傳染病的一個門診來分散急診的力量的一個人力的量能的承擔所以這樣的一個情況那當然我們的確這次的就診人數比較多就診人數比較多後闖的就比較多那其實這個部分我們都完全的有訴訟的掌控那自己急診醫學會其實我跟 |
| transcript.whisperx[19].start |
451.52 |
| transcript.whisperx[19].end |
470.415 |
| transcript.whisperx[19].text |
集子醫學院的理事長是非常熟悉所以我們一直在討論那他們可能集子醫學院本身也覺得必須要呼籲當然他要發布這個我是尊重而且我們悉心因為總是要面對問題嘛那問題出來就是來解決啊所以那個 |
| transcript.whisperx[20].start |
471.676 |
| transcript.whisperx[20].end |
487.516 |
| transcript.whisperx[20].text |
我們來探討NEC是一回事解決困難才是重要的所以我們就馬上發動NEC的一個調配的機制第二個我們也發動區域的聯防第三個我們更是希望民眾如果有任何問題是不是優先先到你的 |
| transcript.whisperx[21].start |
488.837 |
| transcript.whisperx[21].end |
504.665 |
| transcript.whisperx[21].text |
各地的一個社區診所先做一個screen因為可能很多流感啊那種病毒在那邊處理就好了這是一個短暫那我們持續這樣努力的就是我們護理的工作環境待遇跟一個環境另外也 |
| transcript.whisperx[22].start |
505.325 |
| transcript.whisperx[22].end |
522.004 |
| transcript.whisperx[22].text |
健保署馬上在處理集中症方面的一個給付這個部分也馬上會來5月會來落實我們緊急希望來改善未來我們會更聆聽各方的聲音看看怎麼樣來共同來面對這個醫療界的一個很重要的問題 |
| transcript.whisperx[23].start |
523.085 |
| transcript.whisperx[23].end |
545.944 |
| transcript.whisperx[23].text |
部長我想不用聆聽了你直接要到現場到戰場去實地的了解這個我想很多面相要討論也有面相要處理對不對但是我們簡單講一下基層醫學會特別有做這樣的呼籲我在波文也特別提到我不曉得你們到現在為何不可以去掌控 |
| transcript.whisperx[24].start |
546.644 |
| transcript.whisperx[24].end |
574.991 |
| transcript.whisperx[24].text |
掌握了全國像遇到這種兩三類型的流感在交互的時候在盛行的時候那你必須要去掌握全國這些急診室的觀察床還是一般的病床還是這個ICU的使用率還是空床率都有掌握而且15分鐘就會換心理次你們怎麼掌握我們有那個平台哪一個平台可以跟我說清楚哪一個平台嗎 |
| transcript.whisperx[25].start |
576.868 |
| transcript.whisperx[25].end |
604.302 |
| transcript.whisperx[25].text |
對於急診的及時就醫人數的話其實我們是自動間接醫院的掛號系統所以是說每15分鐘登記一次所以就醫的來診量跟住院的在ICU特別是加護病房因為現況的部分其實塞車的都是那幾家大醫院然後以這樣子的來說的話其實我們在部裡面的政策其實就是重症不漏接然後那個系統基本上面就是連從我們的 |
| transcript.whisperx[26].start |
605.562 |
| transcript.whisperx[26].end |
629.43 |
| transcript.whisperx[26].text |
衛福部的緊急藥管理系統裡面去接醫院的掛號的一個系統以上就是就是到醫院的一個掛號系統你們去透過那個系統去掌握掌握病床數ICU急診的觀察床急診的待床人數急診的待床人數然後跟所謂的那個我們加護病房的空床數使用率 |
| transcript.whisperx[27].start |
630.69 |
| transcript.whisperx[27].end |
641.769 |
| transcript.whisperx[27].text |
那個系統可以那個系統是在給你做這樣的功能還是只有在統計那個後程的功能 |
| transcript.whisperx[28].start |
643.84 |
| transcript.whisperx[28].end |
672.474 |
| transcript.whisperx[28].text |
給民眾的其實很重要的其實民眾需要知道就是哪邊現在有等候很多的後床的人數所以公開給民眾的即時資訊其實是後床的人數每一家醫院的後床人數這是公開給民眾的這是公開給民眾嘛對不對那你衛部你要去掌握嘛對不對那你衛部掌握是透過什麼掌握你是透過這個掌握跟一般民眾去看這個地方的待床數後診數還有我們還要掌握江戶病房的 |
| transcript.whisperx[29].start |
673.602 |
| transcript.whisperx[29].end |
694.151 |
| transcript.whisperx[29].text |
你怎麼掌握嘛哪一個系統掌握我們的緊急醫療管理系統緊急醫療管理系統可以去掌握全國現在遇到這樣的疫情情況之下哪一家醫院還有多少的空床宿哪一家醫院家戶病房 ICU其他沒有嘛急診沒有嘛一般病床沒有嘛或診病人有啊 |
| transcript.whisperx[30].start |
695.592 |
| transcript.whisperx[30].end |
716.723 |
| transcript.whisperx[30].text |
後診病人是後診病人的人數嗎還有等候病後床的就是說我們掌握的除了等候的人數就是還沒被看的嘛然後第二個其實是已經看完以後在流管的人數還有就是說流管確定要住院大概這幾個是我們會持續掌握的人數 |
| transcript.whisperx[31].start |
717.443 |
| transcript.whisperx[31].end |
745.451 |
| transcript.whisperx[31].text |
沒有 這蘇昭薇來行的 你要讓她說她會聽下去喔你說我會不會聽到 有沒有聽到沒有我再請到一邊就對了Common Lighting 你是怎麼掌握你們有什麼系統去掌握Common Lighting 就是你衛護部成立一個指揮中心我知道對一邊有ICU 我知道對一邊還有多少的控窮力我知道對一邊可以怎麼做讓我去做調配嘛 對不對那你是用哪一個系統也是緊急醫療管理系統緊急醫療管理系統 |
| transcript.whisperx[32].start |
746.584 |
| transcript.whisperx[32].end |
775.16 |
| transcript.whisperx[32].text |
不對吧你COVID-19爆發的時候衛生部不是有建設一個叫做全國負壓病房的管理系統當時是為了掌握負壓病房的空床域嘛請139家隔離醫院每日自結合並追蹤管理系統通報負壓病房隔離病床的收治情形嘛對不對讓指揮中心能夠掌握全國負壓病房的即時動態嘛是不是這樣那個是不是啦我要講的是這邊在講的是負壓隔離病房 |
| transcript.whisperx[33].start |
775.72 |
| transcript.whisperx[33].end |
795.937 |
| transcript.whisperx[33].text |
對嘛 這戶要是用這樣處理嘛 對不對對 然後他要人工通報可是我們這邊是直接接醫院的住院管理系統所以是直接自動通報直接接受醫院的住院的系統對好 所以你就可以即時去掌握這家醫院的ICU對的空窗率 空窗數對朝偉 你 朝偉已經在嘆氣了你說對你自己說對 |
| transcript.whisperx[34].start |
805.529 |
| transcript.whisperx[34].end |
807.071 |
| transcript.whisperx[34].text |
每天不管是長官或我們自己內部都有都掌握到11點跟下午3點的一個狀況 |
| transcript.whisperx[35].start |
825.808 |
| transcript.whisperx[35].end |
835.557 |
| transcript.whisperx[35].text |
不過你要看喔你要看COVID-19爆發的時候你們是用什麼呢你們是用這個全國負壓病房的管理系統好然後這個是什麼請139家隔離醫院 |
| transcript.whisperx[36].start |
840.97 |
| transcript.whisperx[36].end |
869.787 |
| transcript.whisperx[36].text |
每日是結合並追蹤管理系統通報這個是人工的我們現在目前這個是我們在講的是傳染病防治所以他是139家醫院我們全國的急救責任醫院是205家所以我們的急救責任醫院的數目遠比隔離醫院來的多然後因為大家人工通報這個增加人工的負荷所以我們這邊的緊急藥管系統是直接借劫然後反而可以減少人力以上 |
| transcript.whisperx[37].start |
871.892 |
| transcript.whisperx[37].end |
890.339 |
| transcript.whisperx[37].text |
真的我們的系統是可以確認你現在可以跟部長講說全國現在哪一家就是205家嘛對不對這家醫院哪邊有空床ICU 監護病房還有後床後床的人後床的人數 |
| transcript.whisperx[38].start |
891.959 |
| transcript.whisperx[38].end |
911.235 |
| transcript.whisperx[38].text |
後診的人數後診跟後診的人數不一樣後診不一定要去後床啊對 後診就是說沒看到的啦是嘛是嘛 沒看到就不一定去變成了等要斷的啦 是啊等要斷的 另外就是ICU 那也很重要嘛ICU的空床現在的狀況啊你我剛才說的等要斷的人沒有代表你我剛才說的你的空白房啊 |
| transcript.whisperx[39].start |
914.142 |
| transcript.whisperx[39].end |
930.1 |
| transcript.whisperx[39].text |
你說地方有六個地方 那就另外一個體系沒關係啦 我覺得現在已經是AI時代嘛AI行動創新內閣如果連這樣的系統都建置得很奇怪如果說今天community的時候還要去借CDC的所謂的結核病最終管理系統 |
| transcript.whisperx[40].start |
931.101 |
| transcript.whisperx[40].end |
950.034 |
| transcript.whisperx[40].text |
那我就覺得到現在沒有把這個東西建設起來這個衛護部有愧對國人這第一件事情第二件事情分級醫療我跟部長講部長特別重視分級醫療但分級醫療不處理妥當的話我們下次的開會還是會再討論到分級醫療這個我都有特別提供出來數字應該也跟你們一樣你自己可以看醫學中心看診率106年看診率是10.65%113年是再往上 |
| transcript.whisperx[41].start |
961.501 |
| transcript.whisperx[41].end |
967.886 |
| transcript.whisperx[41].text |
然後這個113的全國轉整數上轉的數額高達99萬222件下轉的只有10萬08千多件等於是1比9啦如果要說那麼嚴重是1比10啦因為是99萬多嘛 |
| transcript.whisperx[42].start |
980.373 |
| transcript.whisperx[42].end |
992.116 |
| transcript.whisperx[42].text |
若是說對的額度要轉上去的上轉的這個數跟下轉數就是不符合比例所以1比10嘛這個情況一直沒有改善過啊所以我才說你們分級醫療在這個地方就連衛福部都沒有再分級了啦你如果去交代這些大醫院小醫院跟你再做分級醫療 |
| transcript.whisperx[43].start |
1006.397 |
| transcript.whisperx[43].end |
1022.464 |
| transcript.whisperx[43].text |
包委員這個病人如果已經到譬如說到台大醫院你要他到中興醫院去住院那是要揮盡多少我們是揮盡多少苦心跟他說你到中興醫院也可以得到很好的一個照顧還有那邊的總醫師都會來看所以這樣的 |
| transcript.whisperx[44].start |
1024.304 |
| transcript.whisperx[44].end |
1048.174 |
| transcript.whisperx[44].text |
所以第一個應該是先讓民眾知道他的問題到哪邊看是最適合的我剛剛有報告如果他的身體有任何不舒服我們希望他旁邊有社區診所有家庭醫師先跟他過濾他自然就會說你這個我直接去中心醫院斷他就好了不用去台台台你可能要等很久的那裡也沒床等等這些我相信 |
| transcript.whisperx[45].start |
1050.354 |
| transcript.whisperx[45].end |
1071.779 |
| transcript.whisperx[45].text |
這樣這個才是真的分歧醫療啦不然你說的是一個樣態啦有這個樣態這是事實嘛對不對尤其你跟便衣你要再叫一台也不會啦這我們知道啦這很清楚但是我現在是要跟你說你一般接受你要上傳去大型便衣就對了其實像專程當中開到人家的衣繩也會說得很清楚嘛接受衣繩會跟你說你代替找什麼人你去代替找衣繩嘛就很簡單就這樣解決嘛但是 |
| transcript.whisperx[46].start |
1075.2 |
| transcript.whisperx[46].end |
1099.027 |
| transcript.whisperx[46].text |
他來大便宜的 其實他想要大便宜的 舊地的對嗎 異地的他可以去一般接受嘛啊 也行啊對啊 啊這要怎麼處理這要怎麼存這要怎麼存上轉的 這樣處理有高的測試啊 如果他轉下去我們一個也給他幾百塊的一個下轉的費用啊所以那個 所以這個也 這幾天來一直在鼓勵啊 |
| transcript.whisperx[47].start |
1099.967 |
| transcript.whisperx[47].end |
1113.894 |
| transcript.whisperx[47].text |
這個我是確定知道的啦因為我們很鼓勵攤辦性病就盡量轉回社區去去看就好了在大型的醫院的醫師有感想說你去哪家診所嗎轉到哪家診所去嗎 |
| transcript.whisperx[48].start |
1115.143 |
| transcript.whisperx[48].end |
1132.084 |
| transcript.whisperx[48].text |
其實現在都有社區醫療群的制度是沒有錯啦所以那個都大概我台大醫院我們上轉藥到的醫院會很明確啦我們下轉藥到其他診所下轉的醫院有很多它的轄下可能有100家診所對譬如台大醫院的社區醫療群有5個每一個大概有10個 |
| transcript.whisperx[49].start |
1134.266 |
| transcript.whisperx[49].end |
1147.816 |
| transcript.whisperx[49].text |
診所 沒關係啦 不用時間管理啦 要不要給教育委員我自己做主席 我想你可以去掃去我們參考嗎下轉的情況 為什麼會這麼低嘛你們的檢討是在什麼地方 怎麼樣來改善對 一個星期可以給我們嗎好 先保持 先保持謝謝 感謝 謝謝劉建國委員 謝謝部長 |