「明智選擇」先期推行成效──以台灣北部某區域醫院為例

醫療資源的過度使用世界各國都普遍存在的問題，其中多達20%是來自於對病人的益處甚微或傷害的風險可能超過益處的低效益醫療。且在醫療資源使用不斷增加的情況下，各國醫療健保成本每年均大幅度的上升。因此，醫療資源過度使用的議題開始逐漸受到重視，亦積極研究相關策略，期能減少或停止不必要之醫療，讓醫療資源能更有效的被運用。
本院藉由成立整合性跨專業團隊推動Choosing Wisely，期能提供病人有實證而且真正需要的治療，並進一步提升院內醫療照護品質。自108年至今共推行15項主題，其中舉例如「急診昏厥病人腦部電腦斷層執行率」由49.8%下降至3.56%、「末期病人選擇舒適餵食比率」由43%提升至66%等主題皆有效減少不必要之醫療處置，提供病人最適切之醫療服務。

Excessive use of medical resources is a common problem in all countries in the world. As many as 20% of them are caused by low-efficiency medical treatment that has little benefit to the patient or the risk of harm may exceed the benefit. Moreover, with the continuous increase in the use of medical resources, the cost of medical and health insurance in various countries has risen sharply every year. Therefore, the issue of excessive use of medical resources has gradually received attention, and relevant strategies have also been actively studied to reduce or stop unnecessary medical treatment so that medical resources can be used more effectively.
The hospital promotes Choosing Wisely through the establishment of an integrated multi-professional team, hoping to provide patients with evidence-based and truly needed treatment, and to further improve the quality of medical care in the hospital. A total of 15 subjects have been implemented since 2019, such as ''The execution rate of brain computed tomography in asymptomatic adult patients in the emergency'' dropped from 49.8% to 3.56%, and ''The rate of terminally ill patients choosing comfort feeding'' increased from 43% to 66%. All subjects are effective in reducing unnecessary medical treatment and providing patients with the most appropriate medical services.