社團法人臺灣臨床藥學會

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【藥學教育】臺北市推動醫藥分業處方釋出送藥到宅服務歷史紀實
Taipei City Government Promotes Medicine & Drug Clarification Prescription Release and Medicine Home Delivery Service History Document
醫藥分業、處方箋釋出、送藥到宅、藥事照顧、Medicine and Drug Clarification, Prescription Release, Medicine Home Delivery Service, Medical Care
姜郁美Yu-Mei Chiang*1 、吳立雅Li-Ya Wu1 、林昌誠Chung-Chen Lin2 、李慧芝Huey-Jy Lee1 、邱怡玲Yi-Ling Chiu1
1臺北市政府衛生局 、2臺北市立聯合醫院
        國內長期推動醫藥分業效果不彰,推究原因除與民眾「看病到大醫院」的就醫習慣及醫藥常識不足有關外,健保制度「論量計酬」亦可能使得民眾就醫更集中於區域級以上醫院,致使基層醫療日益萎縮,醫療院所處方箋未能釋出情況下,形成醫藥分業的障礙,藥師專業無法發揮。有鑑於此,臺北市自 93 年 7 月起推動「處
方箋釋出與送藥到宅」政策,累計至 94 年 12 月止,社區藥局總計調劑 255,635 張處方箋,藉由「面對面」及「一對一」的用藥諮詢服務,使民眾能「知其所服藥品」, 達到與民眾雙向溝通具體落實社區藥事照護之模式,民眾領藥不再跼限於看診之醫院,而可就近擇合適地點接受藥品調劑諮詢服務,令民眾擁有「自由選擇藥品調劑處所」的權利。「送藥到宅服務」為政策推動中,對民眾最實質且最貼心的便民服務,提供送藥到宅服務一來可以避免患者因行動不便及院內感染之發生,更重要地是能掌握慢性病患長期服藥的狀況,以利病情之監控。 
        本政策除持續加強推動處方箋釋出及送藥到宅服務,並將「免費」送藥到宅服務擴大範圍至智障、精障、肢障、中風、獨居老人,對 65 歲以上年長者有需要「送藥到宅」之慢性病患者,亦列入服務對象,提供市民全方位且迅速便捷的藥事服務; 同時亦持續推動建立用藥安全管理系統,結合基層診所、社區藥局及社區組織等資源,提供在地可近性的用藥安全與藥物諮詢服務,確保病人能用藥正確、完整與持續性的安全照顧。
 
  The long-term domestic promotion on Medicine and Drug Clarification has been low effected; it might be rooted not only in the concept of "see a doctor in the big hospitals" but in the general medical knowledge is insufficient. Also the health insurance system focuses on "the quantity to calculate payment" might possibly cause the populace to go see a doctor in the up-regional level hospitals, which results in the basic unit medical organization service withering day by day. And the prescription notes are not allowed to release under such situation, forms a barrier between medicine and drug clarification, therefore the pharmacists are unable to explore proficiency. Due to this, Taipei City Government began to promote on Prescription Release and Medicine Home Delivery Service policy since July, 2004, accumulates to December, 2004, the community pharmacy in total fills 255,635 prescription notes. Through the affiliation of "face-to-face" and "one-by-one" medicine consultation service, this enables the populace “to understand what medicine is taken”, and achieved the pattern of bidirectional communication with the populace and concrete the pattern of community medicine care matter. The populace therefore take the medicine no longer limited in the hospitals they see a doctor, but may nearby choose the appropriate place to take the drugs to fill prescription consultation service, which enables the populace have "the free choice of the quarter of drug prescription." "Medicine Home Delivery Service" is the most essential and also the most intimate convenient service in all policies promoted, Medicine Home Delivery Service not only to avoid the patients with disability and the district infection. Most importantly, it can control the situation of the chronic patients take medicine for a long time and can monitor the patient’s condition.
    This policy continues to strengthen the policy of Prescription Release and Medicine Home Delivery Service, and will expand the medicine delivering service for the wisdom bonds, the psychological bonds, the strokes, the elder citizens live alone. The senior chronic illness patients above 65 years old who need "Medicine Home Deliver Service " will also being included in the service object, in order to provide the residents omni-directional and convenient medicine service; simultaneously continues to impel the establishment with the medicine safety control system, and so on combines the resources of local clinics, community pharmacy and community organization which would provide local convenience with the medicine security and the medicine consultation service. It will guarantee the patients to be able to take the medicine correctly and the long-term medical safe care.
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