醫療照護中的氣候行動

氣候變遷對醫療系統造成深遠影響，同時醫療活動也是重要的溫室氣體排放源，2017年全球醫療系統的碳排放，約佔全球總排放的5%。台灣醫療部門的碳排放，佔全國總量4.6%，且呈上升趨勢。本研究採用文獻回顧與個案分析相結合的研究設計，從Web of Science核心合輯資料庫，選取2020年1月至2024年9月間發表的32篇英文文獻，聚焦於氣候變遷減緩與永續醫療的相關主題。採用主題分析法，從政策框架與治理機制、臨床實踐與創新、基礎設施與供應鏈管理、教育培訓與能力建設等面向，進行分析。總結國際經驗，並提出適用於臺灣的行動建議。本研究歸納以下主要發現包括：(1)永續醫療核心概念，應整合病人與地球健康；(2)零碳醫療策略應聚焦於提升醫療價值與供應鏈優化；(3)臨床創新包括採用低碳診斷及麻醉方式；(4)系統變革需要從教育、跨領域合作和政策支持層面推進。臺灣醫療體系可借鑒國際經驗，從以下方向推進永續醫療：優化醫療資源配置、推行低碳醫療實踐、建立永續採購制度，並透過政策引導與跨領域合作，逐步實現2050淨零排放的目標。

Climate change has profound impacts on healthcare systems, while healthcare activities are also a significant source of greenhouse gas emissions, accounting for approximately 5% of global emissions in 2017. In Taiwan, healthcare sector emissions represent 4.6% of national total emissions and show an upward trend. This study employed a combined approach of literature review and case analysis, selecting 32 English articles published between January 2020 and September 2024 from the Web of Science Core Collection database, focusing on topics related to climate change mitigation and sustainable healthcare. Using thematic analysis, we examined aspects including policy frameworks and governance mechanisms, clinical practice and innovation, infrastructure and supply chain management, and education and capacity building. We synthesized international experiences and developed recommendations applicable to Taiwan. The study’s key findings include: 1) sustainable healthcare core concepts should integrate patient and planetary health, 2) zero-carbon healthcare strategies should focus on enhancing healthcare value and supply chain optimization, 3) clinical innovations include adopting low-carbon diagnostics and anesthetic methods, and 4) systemic change needs to advance through education, interdisciplinary collaboration, and policy support. Drawing from international experience, Taiwan’s healthcare system can promote sustainable healthcare in the following directions: optimizing healthcare resource allocation, implementing low-carbon medical practices, establishing sustainable procurement systems, and gradually achieving the 2050 net-zero emissions target through policy guidance and cross-disciplinary cooperation.