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FT Chinese Column

Home Research Thought Leadership FT Chinese Column
Revolutionizing Care: Innovative Healthcare Models Transforming Emerging Economies

Revolutionizing Care: Innovative Healthcare Models Transforming Emerging Economies

29 May 2025
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醫療革命:創新模式重塑新興經濟體健康版圖​​

全球醫療體系正經歷巨變。這場變革由患者需求升級、技術突破與對普惠醫療的迫切呼喚共同推動。尤其在資源有限且人口持續增長的國家,面對日益增長的醫療服務需求,創新的醫療服務方式已不是可選項,而是必需項。

發達國家中,患者與全科醫生的平均面診時間僅13至15分鐘。這樣倉促的互動,往往難以解决老齡人群的複雜需要,無法充分解答患者的疑問,也難以進行複雜治療方案所需的必要溝通。發展中國家的困境則更爲嚴峻:醫護短缺與基建不足導致優質醫療觸不可及,最終引發療效不佳、患者不滿與資源浪費的三重危機,全球醫療系統因此承受巨大壓力(見注釋1)。

爲彌補需求上升與醫療供應不足之間的差距,幾種創新的醫療服務方式應運而出。傳統認知中,醫療服務的普及性、費用與質量如同“不可能三角”,改善其中兩方面往往會以犧牲第三方面爲代價。但新興市場的創新實踐正在證明同時滿足三者幷非完全不可能。醫療專家相信在不犧牲醫療質量的情况下,仍有可能改善醫療的普及性及降低費用,尤其對發展中經濟體而言。發達國家專注于虛擬分診、遠程護理和居家醫療等模式,通過數字技術實現服務創新。然而,新興經濟體的首要任務是提升醫療可及性和降低費用。本文將會針對新興經濟體,探討創新的醫療模式如何重塑醫療體系,使其更具韌性幷更好滿足當地人群的實際需要。

​​共享診療(Shared medical appointments)

共享診療是其中一種創新的醫療模式。該模式由一位或幾位醫療人員對患有近似病况的多位病人同時進行集體問診,特別適用于與生活方式有關的疾病,如糖尿病、術後護理、孕産護理、複健等。其優勢在于患者之間可以互相學習,同時醫院也可减少重複工作,减輕工作量。然而,此模式也需面對患者隱私保護、妥善爲患者分組,以及制定合理價格等挑戰。儘管有挑戰,但共享診療對醫療普及性的改善和個體醫療費用的降低,仍令其在許多新興經濟體發展開來,幷在發達國家如英國國家醫療服務體系(NHS)和美國克利夫蘭診所(Cleveland Clinic)進行了試點(參見注釋2)。

藥劑師賦權 (Outsourcing non-critical outpatient care to pharmacists)

另一種模式是將非緊急門診交由藥劑師處理。例如澳大利亞,藥劑師被授權診斷和治療尿路感染,省去了患者必須前往全科醫生的步驟(參見注釋3)。此舉緩解了基層醫療壓力,也爲患者提供了更方便的服務。通過讓藥劑師參與更多非緊急護理,醫療系統能够擴大醫療覆蓋面,减輕其他部門的負擔。

護士主導診療 (Integrating nurse practitioners for primary care)

護士執業醫師(NP)主導診療幷在必要時進行轉診,也是一種創新的醫療模式。南非的“Unjani診療計劃”正是應用了這個模式:護士執業醫師提供基礎醫療護理,幷在必要時通過遠程醫療尋求幫助。這一模式賦能了本地護士,創造了就業機會,爲受艾滋病、結核病等疾病困擾的地區提供可持續的基礎醫療服務。通過將醫療任務轉移給專業醫護人員幷在醫護人員專業知識不足時進行遠程專家諮詢,此模式在降低醫療費用的同時提高了醫療服務的普及性(參見注釋4)。

海外就醫 (Medical tourism)

海外就醫是另一種新醫療模式,爲人們提供了更多的就醫選擇。患者通過專門的中介服務,從醫療成本高、等待時間長的國家出發,前往提供經濟實惠、可以獲取及時治療的國家。本質上,這不僅幫助患者節省了費用,也爲接待就醫的國家帶來了更多收入。東南亞一些私立醫院已成爲此種醫療旅游的熱門目的地,吸引患者進行日常護理或非急需手術等非緊急治療(參見注釋5)。

​雖然這些創新模式充滿潜力,但也面臨諸多挑戰和限制。共享醫療預約只適用于特定疾病狀况,且需要妥善管理隱私保護問題。將護理任務交給藥劑師和護士執業醫師可能導致醫療錯誤及藥品濫用,進而産生嚴重後果。海外就醫在許多方面具有優勢,但也可能破壞醫療公平,給接待國的公共醫療設施造成壓力。接待國還可能因爲需求增加和醫療專業人員被吸引到利潤豐厚的海外就醫行業而面臨內部人才流失,導致本地醫療系統承壓。對于源國家的患者來說,也存在風險,比如護理不够連續或護理質量受損,以及後續跟進的難題。

要讓這些新模式可持續可推廣,必須進行嚴格的試驗、數據收集以及全面的質性和量性研究。通過評估臨床效果、患者滿意度、醫生表現、醫院效率和社會效益,探查這些創新的成效與可行性。醫療服務模式的創新對于滿足新興經濟體的需求至關重要。通過同時解决普及性、費用和質量問題,這些模式能够改變醫療體系,使其更具韌性,更能應對人口的實際需求。然而,謹慎評估這些模式的優劣,以及基于可靠證明的决策,會决定這些模式最終是否能成功。新興經濟體的醫療未來,取决于我們是否能以謹慎且可持續的方式進行創新。

 

學者簡介​​
本文作者Sundara Natarajan Panchanatham爲香港大學經管學院創新及資訊管理學助理教授,研究基于作者近期對多個新興經濟體醫療機構的實地考察,以及與歐洲工商管理學院Yucesan Enver教授、以及印度理工學院Omkar P. Desai教授在公共衛生領域的合作研究成果。

​​

注釋​​:

Note 1: https://pubmed.ncbi.nlm.nih.gov/17850524/

Note 2: https://www.diabetesincontrol.com/wp/content/uploads/PDF/dcms25_intro_sma_pt1.pdf

Note 3: https://www1.racgp.org.au/newsgp/professional/uti-pharmacy-prescribing-goes-nationwide

Note 4: https://www.unjaniclinic.co.za/

Note 5: https://wwwnc.cdc.gov/travel/page/medical-tourism

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