COVID-19疫後傳染病防治醫療網之變革

Post-COVID-19 Reforms of the Communicable Disease Control Medical Network

嚴重特殊傳染性肺炎（Coronavirus disease 2019，COVID-19）大流行歷時三年餘，全面考驗各國傳染病醫療應變體系。臺灣亦在實際應變過程中體認到，現行傳染病防治醫療網在既有架構下之制度性限制。本文回顧我國傳染病防治醫療網之建置背景與運作經驗，整理COVID-19疫情期間於病人收治策略、醫療量能調度、跨體系協作及專業人力配置等面向所面臨之挑戰。並參照世界衛生組織（World Health Organization，WHO）疫後倡議，以及美國、日本之醫療體系改革作法，歸納國際趨勢與可供借鏡之制度設計，進一步彙整國內專家意見與政策討論形成之改革共識，提出疫後我國傳染病防治醫療網之精進策略。包括強化法源基礎、導入能力導向之分級照護架構、佈建特殊病原高階照護量能、補強感染科專業人力，以及挹注資源強化地方整備與輔導功能。期使變革後之傳染病醫療體系平時能維持穩定運作，於危機發生時具備快速擴充與調整之韌性，以因應未來新興傳染病威脅。

The Coronavirus Disease 2019 (COVID-19) pandemic lasted for over three years, posing an unprecedented test to the infectious disease medical response systems of countries worldwide and leading Taiwan to recognize the institutional limitations of its current Communicable Disease Control Medical Network within its existing framework. We reviewed the development and operational experience of Taiwan’s infectious disease control network and summarized the challenges faced during the COVID-19 pandemic regarding patient admission strategies, medical capacity dispatch, cross-system collaboration, and the deployment of professional manpower. Drawing on post-pandemic initiatives proposed by the World Health Organization and healthcare system reforms in the United States and Japan, this paper outlines international trends and adaptable institutional designs, and further synthesizes reform consensus derived from domestic expert opinions and policy discussions to propose enhancement strategies for Taiwan’s post-pandemic infectious disease control network. These strategies include strengthening the legal foundation, introducing a competency-based tiered care framework, establishing high-level care capacity for high-consequence pathogens, reinforcing professional manpower in infectious disease specialties, and injecting resources to strengthen local preparedness and guidance functions, with the ultimate goal of ensuring that the reformed infectious disease medical system can maintain stable operations during ordinary times while possessing the resilience for rapid expansion and adjustment during crises to effectively respond to future emerging infectious disease threats.