組合式照護治療模式─提升慢性阻塞性肺病醫療照護品質

慢性阻塞性肺病(chronic obstructive pulmonary disease, COPD)是一種慢性呼吸道發炎且不可逆性的疾病。2021年慢性下呼吸道疾病在十大死因中排名第8位，依據健保資料庫研究顯示，COPD人急性發作住院的死亡率為4%，平均醫療費用約為新台幣9萬1千餘元，造成70歲以下生命年數損失約11年，這些證據均顯示 COPD影響國人健康甚鉅。2017年由衛生福利部開辦全民健康保險慢性阻塞性肺病醫療給付改善方案，依照台灣胸腔暨重症加護醫學會所制定的照護指引，開始有計畫的積極治療與收案；同時財團法人醫院評鑑暨 醫療品質策進會（簡稱醫策會）也在2017年開辦「慢性阻塞性肺病照護品質認證」，於各醫療機構推行此 疾病認證，目的皆在於提升COPD治療的照護品質，藉由建構組合式照護治療模式，來提升醫療照護品質。  Chronic obstructive pulmonary disease (COPD) is a chronic and irreversible respiratory inflammation disease. In 2021, chronic lower respiratory diseases were ranked as the 8th leading cause of death in Taiwan. According to research using the National Health Insurance Research Database, acute exacerbation of COPD has a mortality rate of 4%, results in average annual medical expenses of approximately NT$91,000 per patient, and leads to numerous symptoms and complications. In 2017, the Ministry of Health and Welfare launched the National Health Insurance COPD Medical Payment Improvement Program by the guidelines of the Taiwan Society of Pulmonary and Critical Care Medicine (TSPCCM) and began developing plans for active patient enrollment and treatment. The Joint Commission of Taiwan (JCT) also launched the “Disease Specific Care - Chronic Obstructive Pulmonary Disease (DSC-COPD)” certification program in 2017 and certified many medical institutions in an effort to improve the quality of COPD care. In this paper, we summarize the series of plans created by the TSPCCM, JCT, and COPD-certified medical institutions that can be used to develop a combined care and treatment model for COPD.