外島醫療的現況與挑戰：以衛生福利部金門醫院為例

The Current Situation and Challenges of Healthcare in an Outlying Island of Taiwan, Taking Kinmen Hospital, Ministry of Health and Welfare as an Example

衛生福利部金門醫院位於離島，原為金門縣立醫院，後改制為衛生福利部金門醫院。身為金門縣境內唯一一間醫院，病患無論疾病輕重，皆至金門醫院就醫，當患者有轉診需求時，須透過空中轉診至台灣。鑑於離島醫療資源不足，中央及地方政府積極培育在地公費醫師。金門縣常住人口不多，醫療市場規模小，金門醫院經營不易，因此積極爭取中央及地方資源補助。臺北榮民總醫院透過IDS計畫與金門醫院建立醫療合作關係已久，2015年進一步由衛生福利部、金門縣政府、臺北榮民總醫院建立三方共同經營模式。增加醫師人力及建置軟硬體設備為改善醫療環境方式之一，然而人力與設備既是資產亦是成本，金門醫院即將面臨無法容納過多公費醫師情形，中央及地方政府應及早思考因應之道。

Kinmen Hospital, affiliated to the Ministry of Health and Welfare (MOHW), is located on a remote island of Taiwan. It was originally belonged to Kinmen County, then was reorganized and subject to the governance of the MOHW. As the only hospital in the county, regardless of the severity of the illness, they all come to Kinmen Hospital for help. When patients require a referral, they would be transferred to Taiwan via aerotransportation. Considering the inadequate medical resources on the island, central and local governments proactively train local students to become competent physicians. Due to the small resident population in the county, the medicine market is limited, posing challenges in managing Kinmen Hospital. Therefore, the hospital actively seeks resource subsidies from the central and local governments. The medical collaboration between Taipei Veterans General Hospital (TVGH) and Kinmen Hospital has been long-standing, as a result, in 2015, a tripartite cooperative model was further established among MOHW, Kinmen County Government, and TVGH. Increasing physician manpower and establishing hardware equipment are among the ways to improve the healthcare environment. However, both manpower and equipment are not only assets but also costs. In the coming years, Kinmen Hospital would face challenges in accommodating an excessive number of government-sponsored physicians. The central and local governments should promptly consider measures to address this situation.