| 摘要: | 本研究旨在評估長庚紀念醫院於桃園市復興區華陵醫療站所推動之遠距醫療服務，對不同利害關係人所創造之社會價值。疫情期間，台灣政府大幅鬆綁遠距醫療限制，使得相關服務快速擴展。然而，隨著 2023 年疫情趨緩，通訊診療的適用範圍逐步收窄，遠距醫療的發展也面臨政策與制度上的不確定性。本研究即在此政策轉折背景下，探討遠距醫療是否具備持續推動之社會效益與制度正當性。
研究採用社會投資報酬率做為評估方式，將病患、醫師與護理師三類利害關係人納入評估範圍，透過病患通勤成本節省、醫護人員工時與心理價值金額化，計算其整體社會價值，並納入四大修正因子用以提高估值的準確性與真實性，計算出其社會投資報酬率為0.1238元。同時，本研究亦運用偏最小平方法結構方程模型（PLS-SEM），驗證醫療人員對遠距問診使用意願之心理機制，建立其行為傾向與價值認知間之結構邏輯。
此外，文中也點出了本研究在評估遠距醫療社會投資報酬率上所遭遇到的諸多限制，例如利害關係人範疇的侷限或是資料取得受到現行法規限制等問題。最後本研究也針對華陵醫療站的遠距醫療專案提出見解，雖結果顯示社會投資報酬率僅為0.1238，反映專案在財務回收上尚未達成平衡，但仍舊肯定該專案於公益服務框架的價值，且由於成本結構以及民眾認知等諸多原因，使得該專案展現出在長期運行下的蓬勃發展潛力，有望實現真正意義上的未來可期。
;This study aims to evaluate the social value created for different stakeholders by the telemedicine services implemented by Chang Gung Memorial Hospital at the Hualing Medical Station in Fuxing District, Taoyuan City. During the COVID-19 pandemic, the Taiwanese government substantially relaxed regulations on telemedicine, leading to rapid expansion of related services. However, as the pandemic tapered off in 2023, the scope of teleconsultations was progressively narrowed, and the development of telemedicine has since faced policy and institutional uncertainty. Against this backdrop of shifting regulations, this research investigates whether telemedicine possesses enduring social benefits and institutional legitimacy.
We adopt the Social Return on Investment (SROI) framework as our evaluation method, incorporating three stakeholder groups—patients, physicians, and nurses—into the analysis. By monetizing patient travel-cost savings, medical staff time savings, and psychological benefits, and applying four adjustment factors to enhance estimation accuracy and realism, we calculate an overall SROI of 0.1238. Concurrently, we employ Partial Least Squares Structural Equation Modeling (PLS-SEM) to validate the psychological mechanisms underlying healthcare providers’ intention to use teleconsultation, establishing the structural logic between behavioral inclination and value perception.
Furthermore, this paper highlights several limitations encountered in assessing the SROI of telemedicine, such as the restricted scope of stakeholder inclusion and regulatory constraints on data access. Finally, we offer insights on the Hualing Medical Station telemedicine program. Although the computed SROI of 0.1238 indicates that the project has not yet achieved financial equilibrium, we affirm its value within a public-service framework. Moreover, due to its cost structure and evolving user perceptions, this program demonstrates significant growth potential over the long term—truly a case where “the future looks promising.” |
