| IVOD_ID |
167669 |
| IVOD_URL |
https://ivod.ly.gov.tw/Play/Clip/1M/167669 |
| 日期 |
2026-03-18 |
| 會議資料.會議代碼 |
委員會-11-5-26-2 |
| 會議資料.會議代碼:str |
第11屆第5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 |
5 |
| 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5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 |
2026-03-18T13:34:31+08:00 |
| 結束時間 |
2026-03-18T13:44:53+08:00 |
| 影片長度 |
00:10:22 |
| 支援功能[0] |
ai-transcript |
| 支援功能[1] |
gazette |
| video_url |
https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/4e26a61b53ad6053e9b3fffab9f57a1f18cbbd4f69c426c0ff312b132094bbea9efbac3bee55a0345ea18f28b6918d91.mp4/playlist.m3u8 |
| 委員名稱 |
劉建國 |
| 委員發言時間 |
13:34:31 - 13:44:53 |
| 會議時間 |
2026-03-18T09:00:00+08:00 |
| 會議名稱 |
立法院第11屆第5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、勞動部、原住民族委員會、內政部、教育部、行政院人事行政總處、銓敘部及國家衛生研究院，就「如何精進偏鄉醫療與長照資源落差及落實《原住民族健康法》之困境，並對提升原住民族健康權益及強化原鄉照護量能（含提升機關位階與人力配置）」進行專題報告，並備質詢。
【3月18日及3月19日，二天一次會】） |
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石部長崇良 |
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0.859 |
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石部長崇良 |
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SPEAKER_02 |
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劉委員建國 |
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石部長崇良 |
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劉委員建國 |
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石部長崇良 |
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劉委員建國 |
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劉委員建國 |
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石部長崇良 |
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劉委員建國 |
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石部長崇良 |
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SPEAKER_01 |
| transcript.pyannote[151].speaker_name |
石部長崇良 |
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| transcript.whisperx[0].start |
5.756 |
| transcript.whisperx[0].end |
21.049 |
| transcript.whisperx[0].text |
謝謝主席有請這個破例始祖 全都不是問題 全力支持的史部長柏定你好 做民意代表同樣聽到 行政官員 應職顧委 職不是問題 專業職持這屆委差不多要顧兩百三十幾億 麻煩柏定 |
| transcript.whisperx[1].start |
30.257 |
| transcript.whisperx[1].end |
35.368 |
| transcript.whisperx[1].text |
也希望補充給我回答一下 質疑不是問題專業支持 我要聽這位阿表要不要再問下去 |
| transcript.whisperx[2].start |
38.854 |
| transcript.whisperx[2].end |
53.297 |
| transcript.whisperx[2].text |
被申訴我知道行情啦 但是委員沒說我不知道這事情以前是衛生署 現在是衛生福利部 那幾屆 官方都說不公平了尤其你是對衛生署的歷史 只是這樣不簡單 背景比較補充所以你的歷練啦 跟你的經驗 跟這幾年多餘 要怎麼支持 要怎麼協調應該都是 大家可以信賴的啦 |
| transcript.whisperx[3].start |
63.228 |
| transcript.whisperx[3].end |
79.715 |
| transcript.whisperx[3].text |
所以不一定算運氣你給他感情高高,感情崩潰就好好,這點我給你記起來錄影給他加起來,對照剛才徐副國跟他的對話好啦,我先感謝我們昨天安排這個專案報告我們要整整這個平衡醫療跟當教的阻礙落差嘛我想我們在這裡,因為我可能把很多 |
| transcript.whisperx[4].start |
91.877 |
| transcript.whisperx[4].end |
108.155 |
| transcript.whisperx[4].text |
這個長者比他還要高其實真的是在衛生署的時代那時候是楊志良署長然後蕭美齡副署長我曾經還把蕭美齡副署長邀集到台中去去看這個在宅醫療當時是針對牙醫的部分 |
| transcript.whisperx[5].start |
109.036 |
| transcript.whisperx[5].end |
129.973 |
| transcript.whisperx[5].text |
然後在林前部長 林卓人部長的時候是在2016我要特別召集到這個諾氏醫院去召開我們改善雲林的可靜性的這樣的一個醫療的可靜性我也要感謝委員會這幾天的努力所以保證化學對照病我們這幾天居家醫療的經費跟使用人數 人數都終於在增加 |
| transcript.whisperx[6].start |
130.533 |
| transcript.whisperx[6].end |
137.44 |
| transcript.whisperx[6].text |
如果從居家醫療及照護的經費10946.54億每年出現增加一直到113.4億、43.09億然後輔助人次居家醫療18萬119然後到113是23萬多重度居家醫療29萬多一直到113是37萬8左右 |
| transcript.whisperx[7].start |
154.295 |
| transcript.whisperx[7].end |
177.843 |
| transcript.whisperx[7].text |
居家中醫這個成長速度更快2523一直到1134 1萬5千多但是不小心再看最後一個居家藥師照護一百九年43一百十年一百四十一百一年一百七十四一百十幾年到三百以內一百十三八十七 |
| transcript.whisperx[8].start |
181.567 |
| transcript.whisperx[8].end |
195.66 |
| transcript.whisperx[8].text |
部長也注意到了部長也有特別去在週六好像週六的時候有受訪未來在長沙3.0在宅醫療及急性後期照護等政策中中醫都將有更要參與的角色 |
| transcript.whisperx[9].start |
198.5 |
| transcript.whisperx[9].end |
224.017 |
| transcript.whisperx[9].text |
這個我們當然全力支持也在關西省過去一直希望中醫可以再跟長照連結更加的內取啦2019年的時候6月健保署公告居家醫療整個計畫將藥師納入居家醫療的一份子針對末期病人的管制藥品以及特殊劑型的用藥指導來提供服務 |
| transcript.whisperx[10].start |
224.998 |
| transcript.whisperx[10].end |
232.588 |
| transcript.whisperx[10].text |
但是我們我們看到現在這樣的一個數據不曉得有掌握嗎為什麼在居家要事的招呼是 |
| transcript.whisperx[11].start |
234.016 |
| transcript.whisperx[11].end |
261.222 |
| transcript.whisperx[11].text |
是這麼低的人次在使用原因出在什麼地方謝謝委員提醒這些健保的服務的服務數據啦我真的是忽略掉那個藥事服務我沒注意到謝謝你給我提醒我還要了解為什麼會掉下來因為健警的穩定在成長每一項的服務我們的居家整合每一項服務其實都是穩定在成長怎麼會藥事服務突然間掉下來我會來了解一下副署長也在這裡 |
| transcript.whisperx[12].start |
263.402 |
| transcript.whisperx[12].end |
269.65 |
| transcript.whisperx[12].text |
我們再分析一下這樣分析一下好嗎?這應該是經紀人嘛,一個禮拜應該怎麼做一些應變跟調整也好,好謝謝因為我們對日本的長照,居家的醫療服務,日本的藥師能夠執行的服務這麼多 |
| transcript.whisperx[13].start |
281.601 |
| transcript.whisperx[13].end |
295.612 |
| transcript.whisperx[13].text |
對不對 送藥到宅 緊急送藥到宅產藥計算 藥力管理用藥的整合評估 用藥執行指導分裝 特殊製劑調製與管理大大大一堆啦那事實上如果你根據食藥署在 |
| transcript.whisperx[14].start |
297.574 |
| transcript.whisperx[14].end |
319.72 |
| transcript.whisperx[14].text |
113年度的國內上市後藥品不良的反應通報案例的分析全國藥物不良反應通報中心共接獲到一萬三千多件然後集中在40-79歲的壯年及老年的病患共佔整體通報案件的54%也就是說長者同時在使用過五種藥物我們媽媽就要抽過五款藥物她會疼疼的 |
| transcript.whisperx[15].start |
323.982 |
| transcript.whisperx[15].end |
342.289 |
| transcript.whisperx[15].text |
有一些狀況會發生他也會忽略國際上對多重用藥的定義醫師、藥師就會去提醒用藥不了環境可能就因為多重用藥還是藥物的交互作用而發生或是加重所以 |
| transcript.whisperx[16].start |
343.69 |
| transcript.whisperx[16].end |
356.656 |
| transcript.whisperx[16].text |
所以這其實有時候我覺得是而且還有針對長者如果是家長記憶的衰退失智、獨居、老老照顧等等除了多重用藥也容易出現吃錯藥的這些狀況重用藥狀況還是服務劑量錯誤等等 |
| transcript.whisperx[17].start |
363.004 |
| transcript.whisperx[17].end |
386.876 |
| transcript.whisperx[17].text |
所以藥師在這個居家醫療照護他扮演的角色絕對是用藥的一個守門人所以特別拜託部長來重視這件事情因為部長有特別提到我去看這個居家醫療照護其實藥師扮演的角色很好他會幫那個病人整理藥還會幫他分隔分天分類 |
| transcript.whisperx[18].start |
388.157 |
| transcript.whisperx[18].end |
416.497 |
| transcript.whisperx[18].text |
我覺得這個藥師服務是在社區藥局可以扮演很重的角色我會來瞭解為什麼這個服務量會下降就一個禮拜嘛我們也可以就是說參照日本的一些藥師的功能的提升加強他的一些資物讓藥師可以扮演的更在3.0裡面可以協助病人提高他的自我照顧能力然後這個跟健保署有關還是請教部長 |
| transcript.whisperx[19].start |
418.158 |
| transcript.whisperx[19].end |
438.957 |
| transcript.whisperx[19].text |
除了居家的藥事照顧之外在者醫療還有很多問題嘛健康署宣稱目前有數千家院所參與居家醫療整合計畫那過去一年這個出診次數為零或僅出診個位數的診所比例有多少能說明嗎出診 |
| transcript.whisperx[20].start |
441.339 |
| transcript.whisperx[20].end |
466.832 |
| transcript.whisperx[20].text |
因為我們這個它是有這個叫做合作關係合作關係的意思是說它有的是診所跟居護所去合作提供居家醫療啦然後我們那個居護所去提供照顧那醫師有的時候是靠遠距居家住院嘛在宅住院那個界位是可以遠距但是至少他要去看一次啦 |
| transcript.whisperx[21].start |
467.812 |
| transcript.whisperx[21].end |
475.379 |
| transcript.whisperx[21].text |
所以不應該有出證為零的這應該是不可能才對這應該是嘛所以你又說應該就代表不可能喔 |
| transcript.whisperx[22].start |
478.967 |
| transcript.whisperx[22].end |
503.203 |
| transcript.whisperx[22].text |
所以你是不是要把這個阻撓我們再整理一下然後第二個是這個例外使用居家醫療的民眾最終還是在醫院死亡的狀況這是不是跟我們叫做醫療不需要離開所居的社區對我們居家醫療有另一個目標就希望他能夠在家往生能夠在居家我們現在還是將近差不多 |
| transcript.whisperx[23].start |
504.204 |
| transcript.whisperx[23].end |
533.364 |
| transcript.whisperx[23].text |
八成的會在醫院不過如果是進入安寧的計畫的就比較多進入安寧的就會比較多在居家安寧計畫的就會比較多在宅往生這個還有一個數據因為時間關係請部長看第三點因為印尼週日對外的一個說法裡面長照三點來我們就是要做各方面的一個強化但是你看到居家 |
| transcript.whisperx[24].start |
534.645 |
| transcript.whisperx[24].end |
539.178 |
| transcript.whisperx[24].text |
醫療的醫師常在反映不知道病人的常常需求常在端也不知道這個居家醫療醫師的意囑 |
| transcript.whisperx[25].start |
541.248 |
| transcript.whisperx[25].end |
565.159 |
| transcript.whisperx[25].text |
所以這兩者應該是相互相整啊怎麼會變成兩邊各做各的對對對 這個委員點出我們之前的問題就是那個兩個資料沒有互接啦所以我們現在正在做資料的互接已經在進行中了嘛就是健保的資料先整合然後長照也有一個長照系統那現在長照跟健保兩邊的資料在就對接了 |
| transcript.whisperx[26].start |
566.059 |
| transcript.whisperx[26].end |
577.482 |
| transcript.whisperx[26].text |
不然你回想一下,這其實喔,日記點說開始要實施其實我們也去參謀日本很多案,很多他們這個對折要經營,我們有理由讓你們看但是我們到現在,2.0變3.0了還有這種問題,就是不應該發生的啦阿現在這個3.0的重點就是要讓它這邊兩邊可以對接應該已經在進行嘗試了嘛,已經在嘗試了好一定要試辦啦,不用對接要試辦多久? |
| transcript.whisperx[27].start |
595.325 |
| transcript.whisperx[27].end |
619.51 |
| transcript.whisperx[27].text |
今天已經跟差不多現在開始沒有啦我們看今年可以開始那個今年內就開始今年內對不起今年還有8個多月你是要在這一季應該上半年就可以了吧上半年上半年就可以了啦好 上半年啦準備要差不多啦OK啦 好 謝謝謝謝部長 謝謝主席 謝謝謝謝中國委員 |
| transcript.gazette[0].speaker |
劉委員建國 |
| transcript.gazette[0].start |
2026-03-18T13:34:36.756000+08:00 |
| transcript.gazette[0].guessed |
|
| transcript.gazette[0].end |
2026-03-18T13:34:45.804000+08:00 |
| transcript.gazette[0].text |
謝謝主席，有請這個魄力十足、錢不是問題、全力支持的石部長。 |
| transcript.gazette[0].quality |
0.76 |
| transcript.gazette[1].speaker |
主席 |
| transcript.gazette[1].start |
2026-03-18T13:34:45.804000+08:00 |
| transcript.gazette[1].guessed |
1 |
| transcript.gazette[1].end |
2026-03-18T13:34:46.804000+08:00 |
| transcript.gazette[1].text |
請石部長。 |
| transcript.gazette[1].quality |
0 |
| transcript.gazette[2].speaker |
石部長崇良 |
| transcript.gazette[2].start |
2026-03-18T13:34:46.804000+08:00 |
| transcript.gazette[2].guessed |
1 |
| transcript.gazette[2].end |
2026-03-18T13:34:47.804000+08:00 |
| transcript.gazette[2].text |
劉委員好。 |
| transcript.gazette[2].quality |
0 |
| transcript.gazette[3].speaker |
劉委員建國 |
| transcript.gazette[3].start |
2026-03-18T13:34:46.024000+08:00 |
| transcript.gazette[3].guessed |
|
| transcript.gazette[3].end |
2026-03-18T13:34:46.124000+08:00 |
| transcript.gazette[3].text |
部長你好。 |
| transcript.gazette[3].quality |
0.5 |
| transcript.gazette[4].speaker |
劉委員建國 |
| transcript.gazette[4].start |
2026-03-18T13:34:47.906000+08:00 |
| transcript.gazette[4].guessed |
|
| transcript.gazette[4].end |
2026-03-18T13:34:50.548000+08:00 |
| transcript.gazette[4].text |
做民意代表的人最喜歡聽到行政官員回應這句話：錢不是問題，全力支持。 |
| transcript.gazette[4].quality |
0.567 |
| transcript.gazette[5].speaker |
劉委員建國 |
| transcript.gazette[5].start |
2026-03-18T13:34:50.648000+08:00 |
| transcript.gazette[5].guessed |
|
| transcript.gazette[5].end |
2026-03-18T13:34:51.869000+08:00 |
| transcript.gazette[5].text |
那我這個計畫差不多要兩百三十幾億，就麻煩部長。 |
| transcript.gazette[5].quality |
0.619 |
| transcript.gazette[6].speaker |
石部長崇良 |
| transcript.gazette[6].start |
2026-03-18T13:34:51.869000+08:00 |
| transcript.gazette[6].guessed |
1 |
| transcript.gazette[6].end |
2026-03-18T13:35:03.442000+08:00 |
| transcript.gazette[6].text |
什麼東西？ |
| transcript.gazette[6].quality |
0 |
| transcript.gazette[7].speaker |
劉委員建國：也希望部長跟我回答一下 |
| transcript.gazette[7].start |
2026-03-18T13:35:03.442000+08:00 |
| transcript.gazette[7].guessed |
|
| transcript.gazette[7].end |
2026-03-18T13:35:03.722000+08:00 |
| transcript.gazette[7].text |
錢不是問題，全力支持。 |
| transcript.gazette[7].quality |
0.667 |
| transcript.gazette[8].speaker |
劉委員建國：也希望部長跟我回答一下 |
| transcript.gazette[8].start |
2026-03-18T13:35:03.803000+08:00 |
| transcript.gazette[8].guessed |
|
| transcript.gazette[8].end |
2026-03-18T13:35:06.188000+08:00 |
| transcript.gazette[8].text |
我只要聽到這句話，後面我就不用再問了。 |
| transcript.gazette[8].quality |
0.412 |
| transcript.gazette[9].speaker |
石部長崇良 |
| transcript.gazette[9].start |
2026-03-18T13:35:10.354000+08:00 |
| transcript.gazette[9].guessed |
|
| transcript.gazette[9].end |
2026-03-18T13:35:13.515000+08:00 |
| transcript.gazette[9].text |
衛生所的部分，我知道行情啦，但是委員沒說，我不知道這是什麼。 |
| transcript.gazette[9].quality |
0.654 |
| transcript.gazette[10].speaker |
劉委員建國 |
| transcript.gazette[10].start |
2026-03-18T13:35:13.735000+08:00 |
| transcript.gazette[10].guessed |
|
| transcript.gazette[10].end |
2026-03-18T13:35:23.657000+08:00 |
| transcript.gazette[10].text |
以前是衛生署，現在是衛生福利部，規格、高度整個都不一樣了，尤其你是從衛生署一路上來，好不容易當部長，所以你的歷練、累積的經驗、錢在哪裡、應該要怎麼支持、應該要怎麼下重力，應該都是大家可以信賴的。 |
| transcript.gazette[10].quality |
0.624 |
| transcript.gazette[11].speaker |
劉委員建國 |
| transcript.gazette[11].start |
2026-03-18T13:35:34.228000+08:00 |
| transcript.gazette[11].guessed |
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| transcript.gazette[11].end |
2026-03-18T13:35:34.528000+08:00 |
| transcript.gazette[11].text |
所以部長你先回應一下。 |
| transcript.gazette[11].quality |
0.3 |
| transcript.gazette[12].speaker |
石部長崇良 |
| transcript.gazette[12].start |
2026-03-18T13:35:34.528000+08:00 |
| transcript.gazette[12].guessed |
1 |
| transcript.gazette[12].end |
2026-03-18T13:35:38.690000+08:00 |
| transcript.gazette[12].text |
沒有啦！ |
| transcript.gazette[12].quality |
0 |
| transcript.gazette[13].speaker |
劉委員建國 |
| transcript.gazette[13].start |
2026-03-18T13:35:38.690000+08:00 |
| transcript.gazette[13].guessed |
|
| transcript.gazette[13].end |
2026-03-18T13:35:40.211000+08:00 |
| transcript.gazette[13].text |
咦，你跟他感情比較好，跟我不太好？ |
| transcript.gazette[13].quality |
0.357 |
| transcript.gazette[14].speaker |
石部長崇良 |
| transcript.gazette[14].start |
2026-03-18T13:35:40.211000+08:00 |
| transcript.gazette[14].guessed |
1 |
| transcript.gazette[14].end |
2026-03-18T13:35:41.211000+08:00 |
| transcript.gazette[14].text |
沒有啦！ |
| transcript.gazette[14].quality |
0 |
| transcript.gazette[15].speaker |
石部長崇良 |
| transcript.gazette[15].start |
2026-03-18T13:35:41.211000+08:00 |
| transcript.gazette[15].guessed |
1 |
| transcript.gazette[15].end |
2026-03-18T13:35:42.211000+08:00 |
| transcript.gazette[15].text |
請委員指教。 |
| transcript.gazette[15].quality |
0 |
| transcript.gazette[16].speaker |
劉委員建國 |
| transcript.gazette[16].start |
2026-03-18T13:35:40.331000+08:00 |
| transcript.gazette[16].guessed |
|
| transcript.gazette[16].end |
2026-03-18T13:35:43.552000+08:00 |
| transcript.gazette[16].text |
好，這一點我幫你記起來，影片節錄起來，對照剛才徐富癸跟你的對話。 |
| transcript.gazette[16].quality |
0.714 |
| transcript.gazette[17].speaker |
劉委員建國 |
| transcript.gazette[17].start |
2026-03-18T13:35:43.552000+08:00 |
| transcript.gazette[17].guessed |
|
| transcript.gazette[17].end |
2026-03-18T13:36:29.784000+08:00 |
| transcript.gazette[17].text |
好啦，我很感謝我們召委今天安排這個專案報告，因為我們要精進偏鄉醫療跟長照的資源落差，我們雲林縣也有很多長者，比例也這麼高，再者，其實真的是在衛生署的時代，當時是楊志良署長、蕭美玲副署長，我曾經還把蕭美玲副署長邀集到臺中去看這個在宅醫療，當時是針對牙醫的部分，然後，在林前部長奏延的時候，即在2016，我還特別召集大家到若瑟醫院去召開我們改善雲林醫療可近性的會議。 |
| transcript.gazette[17].quality |
0.747 |
| transcript.gazette[18].speaker |
劉委員建國 |
| transcript.gazette[18].start |
2026-03-18T13:36:32.026000+08:00 |
| transcript.gazette[18].guessed |
|
| transcript.gazette[18].end |
2026-03-18T13:36:47.178000+08:00 |
| transcript.gazette[18].text |
我們也要感謝衛福部這幾年的努力，所以讓部長看一個對照表，可以看到我們這幾年居家醫療的經費跟使用人次都逐年在增加，如果從居家醫療及照護的經費來看，109年是36.54億，逐年增加，一直到113年是43.09億；服務的人次方面，109年，居家醫療是18.1萬，113年是二十三萬多。 |
| transcript.gazette[18].quality |
0.629 |
| transcript.gazette[19].speaker |
劉委員建國 |
| transcript.gazette[19].start |
2026-03-18T13:36:47.319000+08:00 |
| transcript.gazette[19].guessed |
|
| transcript.gazette[19].end |
2026-03-18T13:36:48.420000+08:00 |
| transcript.gazette[19].text |
重度居家醫療是二十九萬多，一直到113年是37.8萬左右。 |
| transcript.gazette[19].quality |
0.714 |
| transcript.gazette[20].speaker |
劉委員建國 |
| transcript.gazette[20].start |
2026-03-18T13:37:05.295000+08:00 |
| transcript.gazette[20].guessed |
|
| transcript.gazette[20].end |
2026-03-18T13:37:12.897000+08:00 |
| transcript.gazette[20].text |
居家中醫的成長速度更快，2,523，一直到113年是一萬五千多。 |
| transcript.gazette[20].quality |
0.727 |
| transcript.gazette[21].speaker |
劉委員建國 |
| transcript.gazette[21].start |
2026-03-18T13:37:13.898000+08:00 |
| transcript.gazette[21].guessed |
|
| transcript.gazette[21].end |
2026-03-18T13:37:25.802000+08:00 |
| transcript.gazette[21].text |
但是請部長再看最後一欄的居家藥事照護，109年是43、110年是140、111年是174、112年來到326、113年是87。咦？ |
| transcript.gazette[21].quality |
0.567 |
| transcript.gazette[22].speaker |
劉委員建國 |
| transcript.gazette[22].start |
2026-03-18T13:37:32.567000+08:00 |
| transcript.gazette[22].guessed |
|
| transcript.gazette[22].end |
2026-03-18T13:37:33.328000+08:00 |
| transcript.gazette[22].text |
好，部長有注意到了。 |
| transcript.gazette[22].quality |
0.75 |
| transcript.gazette[23].speaker |
劉委員建國 |
| transcript.gazette[23].start |
2026-03-18T13:37:34.228000+08:00 |
| transcript.gazette[23].guessed |
|
| transcript.gazette[23].end |
2026-03-18T13:37:46.640000+08:00 |
| transcript.gazette[23].text |
上周六部長在受訪時就說未來在長照3.0、在宅醫療及急性後期照護等政策中，中醫都將有更重要的參與角色。 |
| transcript.gazette[23].quality |
0.8 |
| transcript.gazette[24].speaker |
劉委員建國 |
| transcript.gazette[24].start |
2026-03-18T13:37:49.500000+08:00 |
| transcript.gazette[24].guessed |
|
| transcript.gazette[24].end |
2026-03-18T13:37:56.025000+08:00 |
| transcript.gazette[24].text |
對此我們當然全力支持，也都樂觀其成，過去我們就一直希望中醫可以跟長照連結，更加的match。 |
| transcript.gazette[24].quality |
0.643 |
| transcript.gazette[25].speaker |
劉委員建國 |
| transcript.gazette[25].start |
2026-03-18T13:38:00.147000+08:00 |
| transcript.gazette[25].guessed |
|
| transcript.gazette[25].end |
2026-03-18T13:38:21.145000+08:00 |
| transcript.gazette[25].text |
2019年6月，健保署也公告居家醫療整合計畫，將藥師納入居家醫療的一分子，針對末期病人的管制藥品以及特殊劑型的用藥指導來提供服務，但是我看到現在這樣的一個數據，部長有掌握嗎？ |
| transcript.gazette[25].quality |
0.934 |
| transcript.gazette[26].speaker |
劉委員建國 |
| transcript.gazette[26].start |
2026-03-18T13:38:21.145000+08:00 |
| transcript.gazette[26].guessed |
|
| transcript.gazette[26].end |
2026-03-18T13:38:25.496000+08:00 |
| transcript.gazette[26].text |
為什麼在居家藥事照護的使用人次是這麼低？ |
| transcript.gazette[26].quality |
0.632 |
| transcript.gazette[27].speaker |
劉委員建國 |
| transcript.gazette[27].start |
2026-03-18T13:38:27.677000+08:00 |
| transcript.gazette[27].guessed |
|
| transcript.gazette[27].end |
2026-03-18T13:38:28.457000+08:00 |
| transcript.gazette[27].text |
原因出在什麼地方？ |
| transcript.gazette[27].quality |
1 |
| transcript.gazette[28].speaker |
石部長崇良 |
| transcript.gazette[28].start |
2026-03-18T13:38:28.997000+08:00 |
| transcript.gazette[28].guessed |
|
| transcript.gazette[28].end |
2026-03-18T13:38:51.401000+08:00 |
| transcript.gazette[28].text |
謝謝委員提醒這是健保的服務數據，我真的是忽略掉那個藥事服務，我沒注意到，謝謝你的提醒，我要去了解為什麼會掉下來，因為我們那個居家整合的每一項服務之前都是穩定在成長，為什麼藥事服務會突然間掉下來，我會來了解一下……好。 |
| transcript.gazette[28].quality |
0.878 |
| transcript.gazette[29].speaker |
石部長崇良 |
| transcript.gazette[29].start |
2026-03-18T13:38:51.721000+08:00 |
| transcript.gazette[29].guessed |
|
| transcript.gazette[29].end |
2026-03-18T13:38:55.123000+08:00 |
| transcript.gazette[29].text |
副署長也在這裡，我們回去之後會再分析一下。 |
| transcript.gazette[29].quality |
0.737 |
| transcript.gazette[30].speaker |
劉委員建國 |
| transcript.gazette[30].start |
2026-03-18T13:38:55.183000+08:00 |
| transcript.gazette[30].guessed |
|
| transcript.gazette[30].end |
2026-03-18T13:38:55.584000+08:00 |
| transcript.gazette[30].text |
對，再分析一下，好不好？ |
| transcript.gazette[30].quality |
0.556 |
| transcript.gazette[31].speaker |
劉委員建國 |
| transcript.gazette[31].start |
2026-03-18T13:38:55.684000+08:00 |
| transcript.gazette[31].guessed |
|
| transcript.gazette[31].end |
2026-03-18T13:38:55.684000+08:00 |
| transcript.gazette[31].text |
這應該很快吧？ |
| transcript.gazette[31].quality |
0.5 |
| transcript.gazette[32].speaker |
劉委員建國 |
| transcript.gazette[32].start |
2026-03-18T13:38:56.124000+08:00 |
| transcript.gazette[32].guessed |
|
| transcript.gazette[32].end |
2026-03-18T13:38:57.726000+08:00 |
| transcript.gazette[32].text |
一個禮拜應該可以看要怎麼做一些應變跟調整。好。 |
| transcript.gazette[32].quality |
0.81 |
| transcript.gazette[33].speaker |
劉委員建國 |
| transcript.gazette[33].start |
2026-03-18T13:38:57.826000+08:00 |
| transcript.gazette[33].guessed |
|
| transcript.gazette[33].end |
2026-03-18T13:39:13.242000+08:00 |
| transcript.gazette[33].text |
謝謝，因為我們如果對照日本的長照居家醫療服務，日本的藥師能夠執行的服務項目這麼多，對不對？ |
| transcript.gazette[33].quality |
0.878 |
| transcript.gazette[34].speaker |
劉委員建國 |
| transcript.gazette[34].start |
2026-03-18T13:39:13.242000+08:00 |
| transcript.gazette[34].guessed |
|
| transcript.gazette[34].end |
2026-03-18T13:39:24.190000+08:00 |
| transcript.gazette[34].text |
送藥到宅或緊急送藥到宅、殘藥計算、藥歷管理、用藥的整合評估、用藥諮詢與指導、用藥分裝、特殊製劑調製與管理等等，一大堆。 |
| transcript.gazette[34].quality |
0.784 |
| transcript.gazette[35].speaker |
劉委員建國 |
| transcript.gazette[35].start |
2026-03-18T13:39:25.150000+08:00 |
| transcript.gazette[35].guessed |
|
| transcript.gazette[35].end |
2026-03-18T13:40:11.769000+08:00 |
| transcript.gazette[35].text |
事實上，如果根據食藥署在113年度的國內上市後藥品不良反應通報案例分析結果，全國藥物不良反應通報中心共接獲一萬三千多件，然後集中在40到79歲的壯年及老年病患共占整體通報案件的54%，也就是說，長者在同時使用五種藥物時，像我媽媽就超過五種藥，他常常會有一些狀況發生，他也就會符合國際對多重用藥的定義，醫師、藥師就會去提醒，用藥有不良反應，可能是因為多重用藥還是藥物的交互作用而發生或是加重。 |
| transcript.gazette[35].quality |
0.844 |
| transcript.gazette[36].speaker |
劉委員建國 |
| transcript.gazette[36].start |
2026-03-18T13:40:18.832000+08:00 |
| transcript.gazette[36].guessed |
|
| transcript.gazette[36].end |
2026-03-18T13:40:40.067000+08:00 |
| transcript.gazette[36].text |
還有針對長者，如果加上記憶的衰退、失智、獨居、老老照顧等等，除了多重用藥，也容易出現吃錯藥的狀況、重複用藥的狀況，還有服用劑量錯誤等等，所以藥師在居家醫療照護中扮演的角色，其實是用藥上的一個守門人。對。 |
| transcript.gazette[36].quality |
0.876 |
| transcript.gazette[37].speaker |
劉委員建國 |
| transcript.gazette[37].start |
2026-03-18T13:40:42.228000+08:00 |
| transcript.gazette[37].guessed |
|
| transcript.gazette[37].end |
2026-03-18T13:40:47.491000+08:00 |
| transcript.gazette[37].text |
所以特別拜託部長來重視這件事情，然後因為部長有特別提到…… |
| transcript.gazette[37].quality |
0.923 |
| transcript.gazette[38].speaker |
石部長崇良 |
| transcript.gazette[38].start |
2026-03-18T13:40:47.791000+08:00 |
| transcript.gazette[38].guessed |
|
| transcript.gazette[38].end |
2026-03-18T13:41:06.582000+08:00 |
| transcript.gazette[38].text |
跟委員說明，我去看了居家醫療照護，其實藥師扮演的角色很好，他會幫病人整理藥，還會幫他分格、分天、分類，我覺得藥事服務在社區藥局可以扮演很重的角色，我會來了解為什麼這方面的服務量會下降。 |
| transcript.gazette[38].quality |
0.855 |
| transcript.gazette[39].speaker |
劉委員建國 |
| transcript.gazette[39].start |
2026-03-18T13:41:08.003000+08:00 |
| transcript.gazette[39].guessed |
|
| transcript.gazette[39].end |
2026-03-18T13:41:08.444000+08:00 |
| transcript.gazette[39].text |
好，就一個禮拜……好。 |
| transcript.gazette[39].quality |
0.714 |
| transcript.gazette[40].speaker |
劉委員建國 |
| transcript.gazette[40].start |
2026-03-18T13:41:09.104000+08:00 |
| transcript.gazette[40].guessed |
|
| transcript.gazette[40].end |
2026-03-18T13:41:20.112000+08:00 |
| transcript.gazette[40].text |
我們也可以參照日本一些相關藥師功能的提升，加強他的一些支付，讓藥師在3.0裡面可以扮演更…… |
| transcript.gazette[40].quality |
0.8 |
| transcript.gazette[41].speaker |
石部長崇良 |
| transcript.gazette[41].start |
2026-03-18T13:41:21.633000+08:00 |
| transcript.gazette[41].guessed |
|
| transcript.gazette[41].end |
2026-03-18T13:41:24.775000+08:00 |
| transcript.gazette[41].text |
可以協助病人提高他的自我照顧能力。好。 |
| transcript.gazette[41].quality |
0.941 |
| transcript.gazette[42].speaker |
劉委員建國 |
| transcript.gazette[42].start |
2026-03-18T13:41:26.316000+08:00 |
| transcript.gazette[42].guessed |
|
| transcript.gazette[42].end |
2026-03-18T13:41:49.937000+08:00 |
| transcript.gazette[42].text |
接著請教的是跟健保署有關的，但我還是請教部長，除了居家的藥事照護之外，在宅醫療還有很多的問題，健保署宣稱，目前有數千家院所參與居家醫療整合計畫，過去一年「出診次數為零」或「僅出診個位數」的診所比例有多少，能說明嗎？ |
| transcript.gazette[42].quality |
0.863 |
| transcript.gazette[43].speaker |
石部長崇良 |
| transcript.gazette[43].start |
2026-03-18T13:41:49.937000+08:00 |
| transcript.gazette[43].guessed |
|
| transcript.gazette[43].end |
2026-03-18T13:41:49.957000+08:00 |
| transcript.gazette[43].text |
出診次數為零？ |
| transcript.gazette[43].quality |
0.333 |
| transcript.gazette[44].speaker |
石部長崇良 |
| transcript.gazette[44].start |
2026-03-18T13:41:52.339000+08:00 |
| transcript.gazette[44].guessed |
|
| transcript.gazette[44].end |
2026-03-18T13:42:24.497000+08:00 |
| transcript.gazette[44].text |
因為這個是叫做合作關係，合作關係的意思是有的是診所跟居護所去合作提供居家醫療，然後我們的居護所去提供照顧，醫師有的時候是靠遠距，我們的居家住院即在宅住院計畫中是可以用遠距的方式，但他至少要去看一次，所以不應該有出診次數為零的，這應該是不可能才對，我們來…… |
| transcript.gazette[44].quality |
0.839 |
| transcript.gazette[45].speaker |
劉委員建國 |
| transcript.gazette[45].start |
2026-03-18T13:42:25.018000+08:00 |
| transcript.gazette[45].guessed |
|
| transcript.gazette[45].end |
2026-03-18T13:42:26.359000+08:00 |
| transcript.gazette[45].text |
你說「應該」就代表有可能喔！ |
| transcript.gazette[45].quality |
0.909 |
| transcript.gazette[46].speaker |
劉委員建國 |
| transcript.gazette[46].start |
2026-03-18T13:42:29.967000+08:00 |
| transcript.gazette[46].guessed |
|
| transcript.gazette[46].end |
2026-03-18T13:42:31.068000+08:00 |
| transcript.gazette[46].text |
所以你是不是要把這些資料交代健保署…… |
| transcript.gazette[46].quality |
0.529 |
| transcript.gazette[47].speaker |
石部長崇良 |
| transcript.gazette[47].start |
2026-03-18T13:42:32.629000+08:00 |
| transcript.gazette[47].guessed |
|
| transcript.gazette[47].end |
2026-03-18T13:42:33.550000+08:00 |
| transcript.gazette[47].text |
我們會再整理一下。 |
| transcript.gazette[47].quality |
0.875 |
| transcript.gazette[48].speaker |
劉委員建國 |
| transcript.gazette[48].start |
2026-03-18T13:42:34.791000+08:00 |
| transcript.gazette[48].guessed |
|
| transcript.gazette[48].end |
2026-03-18T13:42:43.817000+08:00 |
| transcript.gazette[48].text |
第二個，使用居家醫療的民眾，最終還是在醫院死亡的狀況，這是不是跟我們在宅醫療的「不需要離開熟悉的社區終老」的精神違背？ |
| transcript.gazette[48].quality |
0.774 |
| transcript.gazette[49].speaker |
石部長崇良 |
| transcript.gazette[49].start |
2026-03-18T13:42:43.817000+08:00 |
| transcript.gazette[49].guessed |
|
| transcript.gazette[49].end |
2026-03-18T13:43:09.033000+08:00 |
| transcript.gazette[49].text |
對，我們居家醫療有訂一個目標，就是希望他能夠在家、居家往生，而我們現在還是有將近八成是在醫院往生，不過，如果是進入居家安寧計畫的，就會有比較多人是在宅往生、終老。 |
| transcript.gazette[49].quality |
0.806 |
| transcript.gazette[50].speaker |
劉委員建國 |
| transcript.gazette[50].start |
2026-03-18T13:43:10.214000+08:00 |
| transcript.gazette[50].guessed |
|
| transcript.gazette[50].end |
2026-03-18T13:43:36.210000+08:00 |
| transcript.gazette[50].text |
我這裡還有一個數據，因為時間的關係，就請部長看第三點，依你周末對外的說法，推動長照3.0，就是要做各方面的強化，但是你可以看到，居家醫療的醫師常反映，不知道病人的長照需求，長照端也不知道居家醫療醫師的醫囑，基本上，這兩者應該是相輔相成，怎麼會變成兩邊各做各的？ |
| transcript.gazette[50].quality |
0.8 |
| transcript.gazette[51].speaker |
石部長崇良 |
| transcript.gazette[51].start |
2026-03-18T13:43:38.171000+08:00 |
| transcript.gazette[51].guessed |
|
| transcript.gazette[51].end |
2026-03-18T13:43:56.139000+08:00 |
| transcript.gazette[51].text |
對、對、對，委員點出我們之前的問題，就是這兩個資料是沒有互接的，所以我們現在正在做資料的互接，這已經在進行中了，就是健保的資料先整合，而長照也有一個長照系統，然後現在長照跟健保兩邊的資料在對接了。 |
| transcript.gazette[51].quality |
0.92 |
| transcript.gazette[52].speaker |
劉委員建國 |
| transcript.gazette[52].start |
2026-03-18T13:43:57.279000+08:00 |
| transcript.gazette[52].guessed |
|
| transcript.gazette[52].end |
2026-03-18T13:44:04.341000+08:00 |
| transcript.gazette[52].text |
部長，你回想一下，當初2.0開始要實施時，我們也去參訪日本他們很多對接上的狀況，他們都已經有這樣的例子給我們看了，但我們現在從2.0要變3.0了，還有這種問題，這是不應該發生的。 |
| transcript.gazette[52].quality |
0.627 |
| transcript.gazette[53].speaker |
石部長崇良 |
| transcript.gazette[53].start |
2026-03-18T13:44:04.581000+08:00 |
| transcript.gazette[53].guessed |
|
| transcript.gazette[53].end |
2026-03-18T13:44:08.042000+08:00 |
| transcript.gazette[53].text |
現在3.0的重點就是要讓這兩邊可以對接，應該已經在進行嘗試了，已經在試辦了，就是對接的部分。 |
| transcript.gazette[53].quality |
0.85 |
| transcript.gazette[54].speaker |
劉委員建國 |
| transcript.gazette[54].start |
2026-03-18T13:44:08.142000+08:00 |
| transcript.gazette[54].guessed |
|
| transcript.gazette[54].end |
2026-03-18T13:44:08.462000+08:00 |
| transcript.gazette[54].text |
要試辦多久？ |
| transcript.gazette[54].quality |
1 |
| transcript.gazette[55].speaker |
石部長崇良 |
| transcript.gazette[55].start |
2026-03-18T13:44:33.206000+08:00 |
| transcript.gazette[55].guessed |
|
| transcript.gazette[55].end |
2026-03-18T13:44:36.267000+08:00 |
| transcript.gazette[55].text |
我看今年內就把它接起來。 |
| transcript.gazette[55].quality |
0.545 |
| transcript.gazette[56].speaker |
劉委員建國 |
| transcript.gazette[56].start |
2026-03-18T13:44:38.488000+08:00 |
| transcript.gazette[56].guessed |
|
| transcript.gazette[56].end |
2026-03-18T13:44:39.468000+08:00 |
| transcript.gazette[56].text |
今年內？ |
| transcript.gazette[56].quality |
1 |
| transcript.gazette[57].speaker |
劉委員建國 |
| transcript.gazette[57].start |
2026-03-18T13:44:39.468000+08:00 |
| transcript.gazette[57].guessed |
|
| transcript.gazette[57].end |
2026-03-18T13:44:43.189000+08:00 |
| transcript.gazette[57].text |
對不起，今年還有八個多月，所以你是不是要在這一季？ |
| transcript.gazette[57].quality |
0.773 |
| transcript.gazette[58].speaker |
石部長崇良 |
| transcript.gazette[58].start |
2026-03-18T13:44:43.389000+08:00 |
| transcript.gazette[58].guessed |
|
| transcript.gazette[58].end |
2026-03-18T13:44:44.369000+08:00 |
| transcript.gazette[58].text |
應該是上半年就可以了吧！ |
| transcript.gazette[58].quality |
0.909 |
| transcript.gazette[59].speaker |
劉委員建國 |
| transcript.gazette[59].start |
2026-03-18T13:44:45.749000+08:00 |
| transcript.gazette[59].guessed |
|
| transcript.gazette[59].end |
2026-03-18T13:44:46.529000+08:00 |
| transcript.gazette[59].text |
好，上半年。 |
| transcript.gazette[59].quality |
1 |
| transcript.gazette[60].speaker |
石部長崇良 |
| transcript.gazette[60].start |
2026-03-18T13:44:47.089000+08:00 |
| transcript.gazette[60].guessed |
|
| transcript.gazette[60].end |
2026-03-18T13:44:47.729000+08:00 |
| transcript.gazette[60].text |
準備得差不多了！ |
| transcript.gazette[60].quality |
0.714 |
| transcript.gazette[61].speaker |
劉委員建國 |
| transcript.gazette[61].start |
2026-03-18T13:44:48.710000+08:00 |
| transcript.gazette[61].guessed |
|
| transcript.gazette[61].end |
2026-03-18T13:44:49.750000+08:00 |
| transcript.gazette[61].text |
OK、好，謝謝部長，謝謝主席。 |
| transcript.gazette[61].quality |
1 |
| transcript.gazette[62].speaker |
石部長崇良 |
| transcript.gazette[62].start |
2026-03-18T13:44:50.350000+08:00 |
| transcript.gazette[62].guessed |
|
| transcript.gazette[62].end |
2026-03-18T13:44:50.350000+08:00 |
| transcript.gazette[62].text |
謝謝委員。 |
| transcript.gazette[62].quality |
0.5 |
| transcript.gazette[63].speaker |
主席 |
| transcript.gazette[63].start |
2026-03-18T13:44:50.350000+08:00 |
| transcript.gazette[63].guessed |
|
| transcript.gazette[63].end |
2026-03-18T13:44:50.510000+08:00 |
| transcript.gazette[63].text |
謝謝劉建國委員。 |
| transcript.gazette[63].quality |
0.714 |
| transcript.gazette[64].speaker |
主席 |
| transcript.gazette[64].start |
2026-03-18T13:44:51.010000+08:00 |
| transcript.gazette[64].guessed |
1 |
| transcript.gazette[64].end |
2026-03-18T13:44:57.867143+08:00 |
| transcript.gazette[64].text |
接下來請高金素梅委員，高金素梅委員，高金素梅委員不在。 |
| transcript.gazette[64].quality |
0 |
| transcript.gazette[65].speaker |
主席 |
| transcript.gazette[65].start |
2026-03-18T13:44:58.167143+08:00 |
| transcript.gazette[65].guessed |
1 |
| transcript.gazette[65].end |
2026-03-18T13:45:03.881429+08:00 |
| transcript.gazette[65].text |
接著請蔡易餘委員，蔡易餘委員，蔡易餘委員不在。 |
| transcript.gazette[65].quality |
0 |
| transcript.gazette[66].speaker |
主席 |
| transcript.gazette[66].start |
2026-03-18T13:45:04.181429+08:00 |
| transcript.gazette[66].guessed |
1 |
| transcript.gazette[66].end |
2026-03-18T13:45:09.895714+08:00 |
| transcript.gazette[66].text |
接著請林德福委員，林德福委員，林德福委員不在。 |
| transcript.gazette[66].quality |
0 |
| transcript.gazette[67].speaker |
主席 |
| transcript.gazette[67].start |
2026-03-18T13:45:10.195714+08:00 |
| transcript.gazette[67].guessed |
1 |
| transcript.gazette[67].end |
2026-03-18T13:45:15.910000+08:00 |
| transcript.gazette[67].text |
接著請鄭正鈐委員，鄭正鈐委員，鄭正鈐委員不在。 |
| transcript.gazette[67].quality |
0 |
| transcript.gazette[68].speaker |
主席 |
| transcript.gazette[68].start |
2026-03-18T13:45:16.210000+08:00 |
| transcript.gazette[68].guessed |
1 |
| transcript.gazette[68].end |
2026-03-18T13:45:18.781429+08:00 |
| transcript.gazette[68].text |
接著請楊曜委員發言。 |
| transcript.gazette[68].quality |
0 |