2006-2019年旅遊醫學合約醫院服務狀況之評估

Evaluation of Travel Medicine Services in Contract Hospitals, Taiwan, 20 0 6 2019

我國出國旅遊人次近10年大幅成長，疾病管制署為降低境外移入傳染病風險，積極推廣旅遊醫學。自2006年起陸續委託醫院簽訂「國際旅遊整合性服務合約醫院（合約醫院）」，提供專案進口（或採購）疫苗預防接種及瘧疾預防用藥、核發國際預防接種證明書、旅遊疾病預防及健康諮詢、留學生健檢及團體衛教等服務。為提高可近性及便利性，擴增至每縣市（含離島地區）至少有一家合約醫院，2019年已有32家合約醫院。
至2019年供旅遊醫學服務已近14年，然綜整性資料闕如，爰蒐集2006年至2019年旅醫門診就診人次、專案進口（或採購）疫苗與藥品使用量及使用者情形，和服務內容運作模式等，檢視發展概況。
經分析合約醫院多數為區域醫院，平均成立7.6年。民眾前往非洲及中南美洲的旅遊人次居高，同時是使用黃熱病疫苗最多。大部分衛生局在查核醫院疫苗冷運冷藏管理時，併同檢視旅醫疫苗之管理，符合疾病管制署對衛生局重視旅醫及疫苗管理之期待。另部分醫院自評門診服務量有成長空間，顯示認同旅遊醫學具發展潛力。
因COVID-19疫情，民眾出國觀光旅遊、其他商務、求學及志工等旅行活動也受到影響，未來將視全球疫情，滾動調整旅遊醫學發展政策，符合世界潮流趨勢。

For the last decade, the annual number of abroad travelers in Taiwan increased substantially. Taiwan Centers for Disease Control (TCDC) has successfully established the International Traveling Integrated Service Contract Hospital (Contract Hospital) since 2006. The services include administration of vaccine importation under specific approval, issuance of international certificates of vaccination or prophylaxis, prescription of malaria chemoprophylactic medications, travel education of infectious diseases prevention and health consultation, health examination for students studying abroad, and group health education. In order to improve the accessibility and convenience of the services, at least one contract hospital had been set up in each county and city (including outlying islands). There were 32Contract Hospitals in 2019.
As of 2019, travel medicine services had been available in Taiwan for almost 14 years. However, comprehensive data was lacking. This research project aimed to review the travel medicine services in Taiwan from 2006 to 2019. Most of the Contract Hospitals are regional hospitals, which had been established for 7.6 years on average. People who travel to countries in Africa and Central or South America visit the travel medicine clinics most often and also administer most yellow fever vaccines. Most local health bureaus met the expectations of TCDC and reviewed hospitals’government-funded vaccine stock management system and travel vaccines simultaneously. The majority of Contract Hospitals responded in the self-assessment indicated the increasing amount of outpatient services in the hospital in the future, showing that Contract Hospitals recognized the potential benefit of the development of travel medicine.
Due to the COVID-19 epidemic, travel abroad and other travel activities such as business, studying, and volunteering are also affected. In the future, it should be based on the overall development of the global epidemic and domestic conditions, and timely adjustment of travel medicine development policy in line with world trends.