周明智白佳原Ming-Chih ChouJar-Yuan Pai林介山Je-Sun Lin醫學研究所2026-10-289999-12-312013https://handle.ncl.edu.tw/11296/err894https://scholars.csmu.edu.tw/handle/123456789/35835SARS期間防疫等級口罩供應量嚴重不足，造成民眾搶購而引起各界的關注。這類防止個體接觸細菌或病毒等傳染物之裝置稱為個人防護裝置（Personal protective equipments, PPEs），其中包含手術用口罩、外科手術手套、N95口罩、防護衣等等，為民眾預防感染和國家防止疾病擴散的主要工具之一。因此本研究主要針對全國個人防護裝備資源配置效益進行研究，研擬可具體有效推動政府、醫院與民間三贏之全國個人防護裝備資源配置模式，以提升防疫物資儲備效率。此次研究包含三部份，一為個人防護裝備採購流通機制之建立；二為拋棄式口罩品質檢驗及認證制度之建立; 第三部份則是外科口罩聯合流通方案法制議題研析。本研究主要包含醫療院所個人防護裝置的使用及採購模式進行普查，並透過文獻資料蒐集、專家會議，並舉辦國內論壇等，提出相關建議，凝聚專家與社會共識。研究之主要發現與結論主要有：1. 抽檢醫院使用之N95 口罩發現口罩之合格率相較以往有大幅提升，但部分醫院在選用口罩之標準仍有所疑慮，因而本計畫統合醫院、廠商、政府三方之觀點，透過採購平台的建置與檢討，以及認證制度之推行方向，並使口罩流通更為透明化、更具體之實行。2. 「醫用面罩聯合採購物流」方案涉及之面向甚廣，致使其合約內容條文包含過於複雜，易造成困擾，建議應簡化並對外推廣說明，更進一步可藉由參與聯合採購案以換取降低個案醫院防疫物資數量與空間之可行。性。3. 「醫用面罩聯合採購物流」之模式推廣應用於N95 口罩時，佩戴密合度成為最需要關注的焦點。唯有正確佩戴N95 口罩使其充分發揮防護效能，方能有效確保醫護人員之生命安全。本研究深入研究發現，如何有效的讓得標廠商將佩戴密合度測試服務費用轉嫁於產品價格內，提供醫療院所完善的售後服務，會是下一階段的推動重點。4. 本研究藉由問卷調查發現，全國醫療院多為單獨招標或聯合招標方式進行採購，大多反映有迫切降低防疫物資的數量與空間需求，且對於疾管局推動「醫用面罩聯合採購物流」大多予以認同與肯定。5. 本研究發現防護衣礙於現行法令規定，依照醫院規模大小要求儲備一個庫存量，然其消耗速度慢，容易有囤積與效期上的問題，且其庫存成本與檢驗價格很高，建議防護衣可採疾管局代為集中保管與流通去化方案。最後，本研究主要建議在於修正政府三級庫存的發展策略，提升全體防疫單位的儲備觀念與效益。建議須全面推動口罩的認證制度，促使國人與醫療院所所購買之口罩是具有更佳之品質保證。This study aims to make a research on the best model of the resource allocation of personal protective equipments (PPEs) among the competent authorities, medical care institutions and suppliers, and hereby recommend a workable model to the concerned policy maker.The study includes three point: First, to establish circulation mechanism of purchasing personal protective equipment; Second, to build the quality inspection and certification system of disposable masks; Third, to analyze the legal issues of surgical masks in joint distribution programs.Methodology in this research includes using a national questionnaire survey to understand the needs and purchasing patterns of medical care institutions. Also, searching literature and holding focus group discussion and national conference condense a common consensus and suggestions from experts and society.The major findings and conclusions include the following five points: 1. After testing N95 masks in hospitals, the qualified rate of inspection masks compared to the past did increase significantly. However, some hospitals doubt about how to select standard mask. Hence, this project intended to integrate three points of views of hospitals, manufactures and governments. Through the building and reviewing purchased platform of masks and implement certification systems enhance distribution in masks more transparent and more practical. 2. Joint procurement of logistics solutions for medical mask involved lots of aspects which causes complicated contents in contract, and result in making trouble easily. And we advice to simplify the description of external promotion, in order to reduce the number and space of hospital for prevention materials through participate in “Joint procurement of logistics solutions for medical mask”. 3. If the model of “Joint procurement of logistics solutions for medical mask” used in N95 masks, and the micro-leakage of wearing is the most important focus. Only the right way to wear N95 masks can get the protection function which can effectively protect the safety of health care. Therefore, the follow-up focus is that the micro-leakage testing services will be included to the prices by the manufacturers in order to provide the hospitals a complete follow-up strategies service. 4. By the questionnaire survey, we found the medical care institutions are either single tendering or union tendering purchased material stocks for the infectious Disease. Most of them reflected they are urgent to reduce the number and space of prevention materials. Also, they had confidence for Centers for Disease Control (CDC) to promote “joint procurement of medical masks logistics”. 5. In accordance with laws and regulations reserve requirements of certain stock, the main problem is the expired date of protective suits, especially the full-face protective suit''s. The protective suit''s consumption rate is very slow; there will be inventory cost and validity issues. Also, stock costs and inspection costs are very high; therefore recommend CDC storage and dagistic protective suit, to avoid wasted that material. Finally, this study suggested that correct the strategy on the three-class stocks policy for all prevention material. Also, this research attempted to develop mask certification systems to enhance quality of masks which people and medical institutions purchase. It is necessary to promote the certification system of masks, in order to make sure the mask quality.thesis