{ "meta": { "version": "2026-10-18.v1.15", "checkedAt": "2026-10-17", "moneyUnit": "十億新臺幣", "evidenceLegend": { "official_observation": "官方統計", "official_audited_observation": "官方審定決算", "official_estimate_reported_by_news": "媒體引述政府推估", "derived_estimate": "由官方數據計算的近似估算", "user_adjustable_assumption": "探索假設", "unknown": "待校準", "fixed_model_assumption": "固定延伸假設", "official_budget_proposal": "官方預算案，非已執行金額", "official_forecast": "官方條件式預估", "survey_sample": "研究樣本，非全國統計", "official_program_budget": "官方計畫經費", "stakeholder_statement_reported_by_news": "媒體轉述團體風險警示，非實證比例", "official_workforce_report": "官方護理人力資料，離職不等於淨流失", "official_policy_guidance": "官方政策說明，非回饋係數", "official_model_guidance": "官方模型指引，非臺灣回饋係數", "prospective_observational_study": "前瞻性觀察研究，非臺灣人口推估係數", "original_workforce_analysis": "原始人力資料分析，非臺灣量能流失係數", "retrospective_care_study": "回溯性照護研究，非年度需求遞延率", "population_utilization_study": "全人口醫療利用研究，非未服務需求留存率" }, "careScenarioAssumptions": { "classification": "sensitivity_assumption", "presets": [ { "name": "保守", "annualCapacityLossPercent": 1, "backlogCarryPercent": 25 }, { "name": "基準", "annualCapacityLossPercent": 2, "backlogCarryPercent": 35 }, { "name": "嚴峻", "annualCapacityLossPercent": 3, "backlogCarryPercent": 50 } ], "basis": "2%僅參考美國醫院護理FTE兩年淨減3.9%的等值年化1.97%量級；1%與3%為人工敏感度幅度。25%／35%／50%為年末未完成照護跨年保留假設，非研究區間。基準指中間參考，非最可能預測。" }, "salaryGrowthReference": { "classification": "derived_scenario_assumption", "source": "https://www.stat.gov.tw/News_Content.aspx?n=2724&s=235863", "officialAnnualTotalSalaryTWD": { "2020": 651336, "2021": 673524, "2022": 696504, "2023": 701040, "2024": 732024, "2025": 760632 }, "cagrPercent": 3.1511090937347497, "defaultFutureGrowthPercent": 3.2, "note": "同版修訂資料、工業及服務業全體受僱員工，含獎金加班。未來成長為可調假設，非官方預測。" }, "medicBaselineReference": { "classification": "cross_study_scenario_assumption", "source": "https://onlinelibrary.wiley.com/doi/10.1155/2023/5599128", "sample": "2019年高雄單一醫學中心500名臨床護理師；2023年發表", "observedOccupationalStressNOSS": 68.86, "observedPersonalBurnoutCBI": 52.25, "observedWorkBurnoutCBI": 48.68, "referenceStaffingPercent": 86.8, "baseFormula": "100 - (100 - 68.86) / 0.868", "defaultBase": 64, "initialWorkloadIndex": 68.752, "note": "職業壓力僅作模型量級參照；兩研究樣本不同，此換算非疲勞量表或全國估計，未證明預測效度。" }, "documentationRevision": "2026-10-18.v1.30", "documentationRevisionNote": "更新公開預設與方法描述，不改原始資料查核日期、模型運算參數或公式。" }, "sources": [ { "id": "nhi2024", "title": "健保署：113年全民健康保險統計", "url": "https://www.nhi.gov.tw/ch/dl-91309-c4228a67fa3a4ff8a277016068582f71-1.pdf", "publisher": "衛生福利部中央健康保險署", "published": "2025-12", "dataDate": "2024", "retrieved": "2026-10-17", "locator": "表38（書頁246；PDF第272頁），表75（書頁374~383；PDF第400~409頁）", "evidence": "official_observation" }, { "id": "nhiHistorical", "title": "健保署：112年全民健康保險統計分析", "url": "https://www.nhi.gov.tw/ch/dl-83055-1f7f22b4844a4320b411080f5cd7c936-1.pdf", "publisher": "衛生福利部中央健康保險署", "dataDate": "2013~2023", "retrieved": "2026-10-17", "locator": "書頁4、24、25（PDF第14、34、35頁）", "evidence": "official_observation" }, { "id": "nhiFinanceAug2026", "title": "健保署：115年8月全民健康保險業務執行報告", "url": "https://www.nhi.gov.tw/ch/dl-102639-dda2a8296a674399ab2815c697415655-1.pdf", "publisher": "衛生福利部中央健康保險署", "published": "2026-09-17", "dataDate": "2026-08-31", "retrieved": "2026-10-17", "locator": "表5（PDF第13頁）、表8（PDF第19頁）；2021~2025為審定決算，2026為月報帳列", "evidence": "official_observation" }, { "id": "nhiFinanceSep2026", "title": "健保署：115年9月全民健康保險基金會計月報", "url": "https://www.nhi.gov.tw/ch/dl-102791-560b681c62cc440ea8bdb83e3d9a1a12-1.pdf", "publisher": "衛生福利部中央健康保險署", "dataDate": "2026-09-30", "retrieved": "2026-10-17", "locator": "平衡表書頁4（PDF第6頁），安全準備；收支餘絀表書頁1~3", "evidence": "official_observation" }, { "id": "policyEstimate", "title": "中央社：衛福部估長者健保費補助約400億元、403萬人", "url": "https://www.cna.com.tw/news/ahel/202610160316.aspx", "publisher": "中央社（引述衛福部文字說明）", "published": "2026-10-16", "dataDate": "2026年底推估", "retrieved": "2026-10-17", "evidence": "official_estimate_reported_by_news" }, { "id": "existingSubsidies", "title": "健保署：各級政府辦理保險對象健保費補助項目一覽表", "url": "https://www.nhi.gov.tw/ch/cp-4721-0d598-2645-1.html", "publisher": "衛生福利部中央健康保險署", "retrieved": "2026-10-17", "evidence": "official_policy_list" }, { "id": "existingCentralBudget", "title": "中央社：行政院說明既有弱勢長者健保費補助", "url": "https://www.cna.com.tw/news/aipl/202610160328.aspx", "publisher": "中央社（引述行政院長）", "published": "2026-10-16", "retrieved": "2026-10-17", "evidence": "official_statement_reported_by_news" }, { "id": "assumptions", "title": "本網站探索假設", "url": null, "publisher": "本網站", "dataDate": "2026-10-17", "retrieved": "2026-10-17", "evidence": "user_adjustable_assumption" }, { "id": "existingSeniorAid2026People", "title": "行政院：全方位守護長者，共築幸福晚美人生", "publisher": "行政院／衛生福利部", "url": "https://www.ey.gov.tw/File/7A5E1D2A73E3B0C6?A=C", "published": "2026-10-15", "dataDate": "2026-05", "locator": "簡報第7頁：115年5月補助70歲以上弱勢老人健保費14萬1,293人", "evidence": "official_observation" }, { "id": "existingSeniorAid2026Budget", "title": "2026年既有70+中低收入長者保費補助預算說明", "publisher": "聯合新聞網（引述行政院發言人）", "url": "https://udn.com/news/story/6656/9819821", "published": "2026-10-16", "dataDate": "2026年度預算", "locator": "12.2億元，非年度實支，未作新法資格逐人去重", "evidence": "official_statement_reported_by_news" }, { "id": "existingSeniorAid2023", "title": "衛福部持續研議弱勢老人健保補助機制，以兼顧世代公平及照顧長者", "publisher": "衛生福利部社會及家庭署", "url": "https://www.mohw.gov.tw/cp-2704-78918-1.html", "published": "2024-05-30", "dataDate": "2023", "locator": "補助112,196人，984,683,000元；另65~69歲由地方訂定基準", "evidence": "official_observation" }, { "id": "annualWage2025", "title": "114年12月及全年工業及服務業薪資統計結果", "publisher": "行政院主計總處", "url": "https://www.stat.gov.tw/News_Content.aspx?n=3703&s=235863", "published": "2026-02-11", "period": "2025全年", "locator": "全體受僱員工每人全年總薪資760,632元，含本外國籍、全時及部分工時；含獎金與加班費。" }, { "id": "nhiPremiumShares", "title": "健保署：保險費負擔比率", "publisher": "衛生福利部中央健康保險署", "url": "https://www.nhi.gov.tw/ch/cp-3257-29d99-2570-1.html", "published": "2022-12-30", "updated": "2023-11-29", "retrieved": "2026-10-17", "locator": "一般公民營事業、機構等有一定雇主受僱者：本人及眷屬30%、投保單位60%、政府10%；其他投保類別比例不同。", "evidence": "official_policy_list", "note": "用於說明等額醫療支撐不等於員工個人實繳保費；未將30/60/10套用為全體健保收入占比。" }, { "id": "nursingWorkload2025", "title": "因應醫院壅塞，衛福部強化三大因應策略", "publisher": "衛生福利部醫事司", "url": "https://www.mohw.gov.tw/cp-2704-81609-1.html", "published": "2025-02-24", "locator": "醫院壅塞造成醫護工作負荷過重；用作角色起始處境的質性依據，未用於分數或疾病風險校準。" }, { "id": "nursingEnvironment2026", "title": "三班護病比入法 用制度支持護理人員", "publisher": "衛生福利部", "url": "https://mohw.gov.tw/cp-2704-86309-1.html", "period": "2026-05", "locator": "每年夜班獎勵47億元、護病比達標獎勵16億元及新手導師3.6億元，合計66.6億元；專款專用，另述健保投入25億元不重複計入此合計", "published": "2026-05-08", "retrieved": "2026-10-17", "evidence": "official_program_budget" }, { "id": "centralBudget2027Draft", "title": "行政院第4017次院會決議：116年度中央政府總預算案", "publisher": "行政院", "url": "https://www.ey.gov.tw/Page/4EC2394BE4EE9DD0/cedadfc2-d9bb-4607-a4ea-fde2114adf82", "published": "2026-08-20", "dataDate": "2027年度預算案", "retrieved": "2026-10-17", "locator": "討論事項二（三）歲入歲出各39,266億元；（五）6 撥補健保基金600億元；屬預算案，非現金可用額或實際撥付", "evidence": "official_budget_proposal" }, { "id": "centralSupplement2026Draft", "title": "行政院院會通過115年度中央政府總預算追加預算案", "publisher": "行政院主計總處", "url": "https://www.dgbas.gov.tw/News_Content.aspx?n=3602&s=236661", "published": "2026-09-03", "dataDate": "2026年度追加預算案", "retrieved": "2026-10-17", "locator": "追加案歲入35,471億元、歲出35,946億元、差短475億元、含還本融資調度2,085億元；未視為已執行決算", "evidence": "official_budget_proposal" }, { "id": "centralDebtAug2026", "title": "健全政府財政，維護財政永續", "publisher": "財政部", "url": "https://www.mof.gov.tw/singlehtml/0de5f2116d744de4bb5e3981dc6fd0b8?cntId=2f5fa31a7c7940e3b4c64ecc91535e8b", "dataDate": "2026-08-31", "retrieved": "2026-10-17", "locator": "中央政府1年以上公共債務未償餘額占前3年度名目GDP平均數：8月底實際22.5%，115年度審議後預算數25.2%", "evidence": "official_observation" }, { "id": "nhi2026ApprovedForecast", "title": "114年全民健康保險會年報：115年度總額預算核定結果及財務試算", "publisher": "衛生福利部全民健康保險會", "url": "https://service.mohw.gov.tw/ebook/nhic/%E5%B9%B4%E5%A0%B1/114/ebook/2025/files/basic-html/page75.html", "dataDate": "2026-01-20核定後的2026年度預估", "retrieved": "2026-10-17", "locator": "電子書第75頁，表3-4：總額9,883.35億元、費率5.17%、年度短絀428億元、年底準備1,651億元及2.16個月；非9月實際數", "evidence": "official_forecast" }, { "id": "subsidyFundingWarning2024", "title": "老人福利法修正恐大幅增加中央支出：修法內容未指明彌補資金來源", "publisher": "行政院新聞傳播處", "url": "https://www.ey.gov.tw/Page/9277F759E41CCD91//93d48b62-9b83-441b-a519-b33d63f03a4e", "published": "2024-12-26", "dataDate": "2024年同類修法提案", "retrieved": "2026-10-17", "locator": "舊提案估新增中央支出384億元，指出未指明彌補資金來源；不是2026年本次修法的最終估算", "evidence": "official_forecast" }, { "id": "medicalAssociationsFundingWarning2026", "title": "中央社：七大醫界團體對長者健保費補助的財源與醫療排擠疑慮", "publisher": "中央社（轉述七大醫界團體共同聲明）", "url": "https://www.cna.com.tw/news/ahel/202610160091.aspx", "published": "2026-10-16", "dataDate": "2026-10-16三讀前共同聲明", "retrieved": "2026-10-17", "locator": "團體擔心缺乏穩定財源將影響基金、費率及護理人力等既有醫療投資；新聞轉述，非已取得團體原始聲明。", "evidence": "stakeholder_statement_reported_by_news", "note": "風險警示未提供排擠比例；網站3%預設為使用者指定情境，非研究估計或已發生支出削減。" }, { "id": "nursingStaffingStudy2026", "title": "三班護病比政策對各層級醫院護理人力的影響與對策—觀察型研究", "publisher": "護理雜誌 73(4):e26406；Wang等人", "url": "https://pubmed.ncbi.nlm.nih.gov/42532817/", "doi": "10.6224/JN.26406", "published": "2026-08", "retrieved": "2026-10-17", "locator": "摘要：207名護理主管與680名護理師線上問卷；實際護理人力/三班最低所需人力平均86.8%（SD22.4）", "evidence": "survey_sample", "note": "研究樣本，非全國普查；摘要未交代問卷收集年份，出版年不等於調查年。86.8%是人力相對最低所需人力，不能解讀為全國只完成86.8%醫療或已有13.2%未服務需求。" }, { "id": "nursingWorkforceFlow2025", "title": "衛福部回復114年11月19日立法院書面質詢：護理人力缺工與執業率", "publisher": "衛生福利部／立法院議事暨公報資訊網", "url": "https://ppg.ly.gov.tw/ppg/SittingAttachment/download/2025111436/22002025450100215003.pdf", "dataDate": "2025年10月執業人數、2024年醫院離職率", "retrieved": "2026-10-17", "locator": "PDF第3頁：2025年10月執業198,564人，同比增加4,908人，醫院增加2,861人；2024年醫院離職率11.58%，2023年12.61%。", "evidence": "official_workforce_report", "note": "離職可能為醫院間流動或轉社區執業，不能當全國淨人力流失率。本網站3%額外有效量能損失未由此推導。" }, { "id": "whoSafeNurseStaffing2026", "title": "WHO／Europe：不安全護理配置可能傷害病人並促使護理人員離開", "publisher": "世界衛生組織歐洲區域辦事處", "url": "https://www.who.int/europe/news/item/18-02-2026-unsafe-nurse-staffing-in-european-region-can-harm-patients-and-drive-nurses-out-of-the-profession", "published": "2026-02-18", "retrieved": "2026-10-17", "locator": "政策說明：人力短缺、工作負荷、倦怠與流失及病人安全的相互影響。", "evidence": "official_policy_guidance", "note": "支持回饋方向，未提供本網站85分、連續兩年、3%量能損失或50%需求遞延的校準。" }, { "id": "queenslandNurseRatio2021", "title": "護病比立法對護理配置、病人死亡、再住院與住院日之影響：前瞻性醫院比較研究", "publisher": "Lancet 397:1905~1913；McHugh等人", "url": "https://pubmed.ncbi.nlm.nih.gov/33989553/", "doi": "10.1016/S0140-6736(21)00768-6", "published": "2021-05-11", "dataDate": "澳洲昆士蘭2016及2018年醫院資料", "retrieved": "2026-10-17", "locator": "27家介入、28家比較醫院；每護理師少照護一名病人的配置改善，與再住院OR0.93、住院日IRR0.97相關。", "evidence": "prospective_observational_study", "note": "支持配置影響後續醫療使用的方向；非臺灣係數，不將勝算比當成發生率，未套為疾病或死亡加成。" }, { "id": "nhsDemandCapacityModels", "title": "NHS England：需求與容量模型及等待存量", "publisher": "NHS England", "url": "https://www.england.nhs.uk/ourwork/demand-and-capacity/service-level-demand-and-capacity-planning/models/", "retrieved": "2026-10-17", "locator": "區分所需容量、可用容量及等待名單，依預約、連續療程、急診等服務路徑選擇模型。", "evidence": "official_model_guidance", "note": "支持延後需求的存量建模，未提供適用臺灣全健保的50%跨年遞延比例。", "technicalGuidanceUrl": "https://www.england.nhs.uk/wp-content/uploads/2019/09/core-model-technical-guidance-v1.0.pdf" }, { "id": "nurseActualTurnover2026", "title": "倦怠、離職意願與實際離職：美國病人照護工作者前瞻性研究", "publisher": "Journal of Occupational and Environmental Medicine；Boden等人", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13496025/", "doi": "10.1097/JOM.0000000000003713", "published": "2026-03-23", "dataDate": "2023年6月至2024年1月問卷；追蹤至2024年底", "retrieved": "2026-10-17", "locator": "表1、表5：1,162位護理師，平均追蹤16.2月，69人實際離職；每週以上倦怠HR3.99（95% CI 1.80~8.83），Cox模型1,068人。", "evidence": "prospective_observational_study", "note": "結局為離開原醫院，含自願、非自願及退休；非離開護理職業或扣除招募後的淨量能流失，不能直接校準3%。" }, { "id": "usNurseFteShock2022", "title": "美國護理師FTE在疫情期間的下降：A Worrisome Drop In The Number Of Young Nurses", "publisher": "Health Affairs Forefront；Auerbach等人", "url": "https://www.healthaffairs.org/content/forefront/worrisome-drop-number-young-nurses", "doi": "10.1377/forefront.20220412.311784", "published": "2022-04-13", "dataDate": "1982~2021；重點2019~2021", "retrieved": "2026-10-17", "locator": "CPS 23~69歲護理師、40小時FTE。2020約320萬，2021年減逾10萬；2019~2021全體下降1.8%、醫院下降3.9%。", "evidence": "original_workforce_analysis", "note": "1.8%及3.9%是兩年合計，不是年度率；逾10萬對約320萬為約3%量級，非精確3.0%估計。疫情多重原因衝擊，不是倦怠因果係數，也不是臺灣持續年減預測。" }, { "id": "usNurseFteRecovery2024", "title": "疫情後美國護理師人力恢復與未來推估", "publisher": "JAMA Health Forum；Auerbach等人", "url": "https://jamanetwork.com/journals/jama-health-forum/fullarticle/2815057", "doi": "10.1001/jamahealthforum.2023.5389", "published": "2024-02-16", "dataDate": "1982年1月至2023年10月CPS；比較2018~2019與2022~2023合併期", "retrieved": "2026-10-17", "locator": "表1：全體FTE 3,163,072→3,353,552，+6.0%（95% CI 1.4~10.6）；醫院1,908,177→1,938,235，+1.6%（-4.3~7.4）。", "evidence": "original_workforce_analysis", "note": "45萬餘位歷年護理師回覆；FTE按40小時工週。疫情後恢復顯示不能把單次下降直接外推成永久年減，且跨照護部門流動不同於全國淨損失。" }, { "id": "entRescheduling2022", "title": "疫情取消耳鼻喉手術的重排與完成率", "publisher": "OTO Open；Sagalow等人", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8977776/", "doi": "10.1177/2473974X221091156", "published": "2022-03-30", "dataDate": "2020/3/16~5/29預約手術，追蹤原定日期後6個月", "retrieved": "2026-10-17", "locator": "Methods、表1及表2：美國單中心833案中取消555案；395案（71.17%）半年內重排並施作，中位70天。", "evidence": "retrospective_care_study", "note": "半年內完成率是流量，非跨年仍待服務存量；其補數不能當翌年保留率。服務類型、時間與資源權重不同，不能校準全健保50%。" }, { "id": "vaCanceledSurgery2021", "title": "疫情取消選擇性手術的短期後果：美國退伍軍人醫療系統", "publisher": "Annals of Surgery；Tran等人", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8187293/", "doi": "10.1097/SLA.0000000000004809", "published": "2021-07", "dataDate": "2020/3/13~19取消案，追蹤30及90天", "retrieved": "2026-10-17", "locator": "Completion Rate、表3：3,326件取消手術，30天內67件（2.0%）、90天內494件（14.9%）完成。", "evidence": "retrospective_care_study", "note": "短期恢復率非年度未完成照護留存率；85.1%的補數也不是一年保留率，不能套為臺灣全健保50%。" }, { "id": "taiwanUtilizationResponse2022", "title": "疫情期間醫療利用的自願反應：臺灣全人口健保資料", "publisher": "PLOS ONE；Tsai、Yang", "url": "https://pubmed.ncbi.nlm.nih.gov/36480549/", "doi": "10.1371/journal.pone.0271810", "published": "2022-12-08", "dataDate": "2020年2~5月，並觀察後續無本土病例期間", "retrieved": "2026-10-17", "locator": "全人口縣市×週健保資料、差異中的差異分析：門診利用下降19%、住院下降10%。", "evidence": "population_utilization_study", "note": "利用量下降包含防疫降低感染與自願改變就醫，不全是量能不足導致未服務；不能用降幅或補數校準跨年需求保留比例。" }, { "id": "nurseStress2019", "title": "Wu等：台灣護理師職業壓力與疲勞研究", "publisher": "Journal of Nursing Management", "url": "https://onlinelibrary.wiley.com/doi/10.1155/2023/5599128", "dataDate": "2019年1~4月；2023年發表", "retrieved": "2026-10-17", "locator": "表2；高雄單一醫學中心500名護理師；職業壓力68.86、個人疲勞52.25、工作疲勞48.68；不同量表", "evidence": "survey_sample" }, { "id": "salaryGrowth2020to2025", "title": "主計總處：2025年12月及全年薪資統計歷年表", "publisher": "行政院主計總處", "url": "https://www.stat.gov.tw/News_Content.aspx?n=2724&s=235863", "dataDate": "2020~2025", "retrieved": "2026-10-17", "locator": "薪資新聞稿11412附件第4頁；2020全年總薪資651,336元、2025年760,632元；5年CAGR3.1511%，未來外推為假設", "evidence": "official_observation" }, { "id": "nurseEnvironment2024", "title": "醫策會：2024年度台灣病人安全文化調查年報", "publisher": "醫策會（臺北榮總公開PDF）", "url": "https://org.vghtpe.gov.tw/savh/files/files/2024年度台灣病人安全文化調查年報(1).pdf", "dataDate": "2024", "retrieved": "2026-10-17", "locator": "表3-2-8（印刷第34頁）；59,966名護理人員工作狀況正向45.10%，比例不換算成疲累分數", "evidence": "survey_sample" } ], "policy": { "eligiblePeople": { "value": 4030000, "unit": "人", "sourceId": "policyEstimate", "date": "2026年底推估", "evidence": "official_estimate_reported_by_news" }, "seniorPeopleForEstimate": { "value": 4850000, "unit": "人", "sourceId": "policyEstimate", "date": "2026年底推估", "evidence": "official_estimate_reported_by_news" }, "annualGrossSubsidyBillion": { "value": 40, "unit": "十億新臺幣／年", "sourceId": "policyEstimate", "date": "2026年底推估", "evidence": "scenario_calibrated_to_reported_scale", "note": "以媒體引述約400億補助量級作模型總額起點；報導也使用增支一詞，未公布去重算式，因此本模型並非重現官方淨增支估算。扣抵既有補助僅為使用者可調情境。" }, "impliedAnnualPremiumPerEligible": { "value": 9925.558312655086, "unit": "新臺幣／人年", "sourceId": "policyEstimate", "date": "2026年底推估", "evidence": "derived_estimate", "note": "以約400億量級÷約403萬校準，不是個人保費；400億報導口徑未提供去重算式，模型明示視為扣抵前量級假設。" }, "eligibleShareOfSeniors": { "value": 0.8309278350515464, "unit": "比例", "sourceId": "policyEstimate", "date": "2026年底推估", "evidence": "derived_estimate", "note": "未來維持此比例屬探索假設。" }, "existingCentralSubsidyBillion": { "value": null, "unit": "十億新臺幣／年", "sourceId": "existingSubsidies", "date": "2026-10-17", "evidence": "unknown", "note": "僅指新政策受益群中既已由中央補助的重疊額，尚未取得。" }, "existingLocalSubsidyBillion": { "value": null, "unit": "十億新臺幣／年", "sourceId": "existingSubsidies", "date": "2026-10-17", "evidence": "unknown", "note": "需跨縣市、補助資格及實際支出年度一致之重疊資料；未知不能填0。" }, "reportedExistingCentralVulnerableBudgetBillion": { "value": 1.22, "unit": "十億新臺幣／年", "sourceId": "existingCentralBudget", "date": "2026", "evidence": "official_statement_reported_by_news", "note": "約12.2億既有弱勢長者相關補助預算；非與本政策403萬人的已核對重疊額，不能直接當去重扣除總額。" }, "incrementalConsolidatedCostBounds": { "min": 0, "max": 40, "unit": "十億新臺幣／年", "sourceId": "assumptions", "date": "2026-10-17", "evidence": "accounting_bound_not_estimate", "note": "未套用70+預算重疊等情境假設前的理論範圍；非統計信賴區間或目前選定情境的計算結果。0不代表推估沒有新增支出。" }, "fundFlowRule": "中央代繳替代原本家戶／地方繳款；若全額如期到帳且資格待遇不變，基金收入不因代繳本身減少或增加。", "existingSeniorAid": { "name": "70歲以上中低收入老人自付健保費全額補助", "budgetYear": 2026, "budgetBillion": 1.22, "budgetEvidence": "official_statement_reported_by_news", "budgetSourceId": "existingSeniorAid2026Budget", "beneficiaries": 141293, "beneficiariesDate": "2026-05", "beneficiariesEvidence": "official_observation", "beneficiariesSourceId": "existingSeniorAid2026People", "historicalYear": 2023, "historicalPeople": 112196, "historicalExpenseBillion": 0.984683, "historicalSourceId": "existingSeniorAid2023", "projectionRule": "2026為基準，未來按70歲以上推估人口比例延伸，非官方預測。", "overlapRule": "是否與新方案資格重疊尚無逐人核對；預設100%為明示情境假設，可停用或調整0~100%。其他補助不取消。" } }, "medical": { "year": 2024, "ageBands": [ { "ageMin": 0, "ageMax": 4, "label": "0~4", "insuredPopulation": 719626, "medicalPoints": 20751000000, "pointsPerInsured": 28835.811936, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 5, "ageMax": 9, "label": "5~9", "insuredPopulation": 966836, "medicalPoints": 19731000000, "pointsPerInsured": 20407.804426, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 10, "ageMax": 14, "label": "10~14", "insuredPopulation": 1000360, "medicalPoints": 12770000000, "pointsPerInsured": 12765.404454, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 15, "ageMax": 19, "label": "15~19", "insuredPopulation": 1015964, "medicalPoints": 12432000000, "pointsPerInsured": 12236.654055, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 20, "ageMax": 24, "label": "20~24", "insuredPopulation": 1351362, "medicalPoints": 16978000000, "pointsPerInsured": 12563.620999, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 25, "ageMax": 29, "label": "25~29", "insuredPopulation": 1655133, "medicalPoints": 23544000000, "pointsPerInsured": 14224.838729, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 30, "ageMax": 34, "label": "30~34", "insuredPopulation": 1780725, "medicalPoints": 30614000000, "pointsPerInsured": 17191.874096, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 35, "ageMax": 39, "label": "35~39", "insuredPopulation": 1730388, "medicalPoints": 34927000000, "pointsPerInsured": 20184.490415, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 40, "ageMax": 44, "label": "40~44", "insuredPopulation": 2051388, "medicalPoints": 48821000000, "pointsPerInsured": 23799.008281, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 45, "ageMax": 49, "label": "45~49", "insuredPopulation": 1999985, "medicalPoints": 60250000000, "pointsPerInsured": 30125.225939, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 50, "ageMax": 54, "label": "50~54", "insuredPopulation": 1759453, "medicalPoints": 66141000000, "pointsPerInsured": 37591.796996, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 55, "ageMax": 59, "label": "55~59", "insuredPopulation": 1763027, "medicalPoints": 79946000000, "pointsPerInsured": 45345.873886, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 60, "ageMax": 64, "label": "60~64", "insuredPopulation": 1745084, "medicalPoints": 97049000000, "pointsPerInsured": 55612.795716, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 65, "ageMax": 69, "label": "65~69", "insuredPopulation": 1553994, "medicalPoints": 106803000000, "pointsPerInsured": 68728.064587, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 70, "ageMax": 74, "label": "70~74", "insuredPopulation": 1256772, "medicalPoints": 105137000000, "pointsPerInsured": 83656.383178, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 75, "ageMax": 79, "label": "75~79", "insuredPopulation": 693354, "medicalPoints": 69980000000, "pointsPerInsured": 100929.683827, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 80, "ageMax": 84, "label": "80~84", "insuredPopulation": 479218, "medicalPoints": 54414000000, "pointsPerInsured": 113547.487782, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } }, { "ageMin": 85, "ageMax": null, "label": "85+", "insuredPopulation": 437303, "medicalPoints": 55151000000, "pointsPerInsured": 126116.216902, "year": 2024, "sourceIds": [ "nhi2024" ], "populationEvidence": "official_observation", "pointsEvidence": "official_observation", "rateEvidence": "derived_estimate", "units": { "insuredPopulation": "人（年底）", "medicalPoints": "點／年（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" } } ], "groups": { "under15": { "population": 2686822, "points": 53252000000, "pointsPerInsured": 19819.697769334925 }, "15to29": { "population": 4022459, "points": 52954000000, "pointsPerInsured": 13164.584151137402 }, "30to44": { "population": 5562501, "points": 114362000000, "pointsPerInsured": 20559.45697807515 }, "45to64": { "population": 7267549, "points": 303386000000, "pointsPerInsured": 41745.2981741162 }, "15to64": { "population": 16852509, "points": 470702000000, "pointsPerInsured": 27930.67785930273 }, "under65": { "population": 19539331, "points": 523954000000, "pointsPerInsured": 26815.350024010546 }, "65plus": { "population": 4420641, "points": 391485000000, "pointsPerInsured": 88558.42399326252 } }, "groupUnits": { "population": "年底納保人", "points": "全年申報點數（含部分負擔）", "pointsPerInsured": "點／年底納保人／年" }, "groupSourceId": "nhi2024", "groupEvidence": "derived_estimate", "totalMedicalPoints": 915440000000, "reportedTotalUnit": "點／年", "reportedTotalSourceId": "nhi2024", "seniorPointsShare": 0.4276468146465088, "seniorTo15to64Ratio": 3.1706507246034064, "seniorTo15to29Ratio": 6.727020236762374, "historyAgeBands": [ "0~14", "15~29", "30~44", "45~64", "65+" ], "history": [ { "year": 2013, "insuredByAge": [ 3280000, 4930000, 5920000, 6670000, 2660000 ], "medicalPointsByAge": [ 41600000000, 47100000000, 89000000000, 207400000000, 203900000000 ], "seniorPointsShare": 0.34617996604414264, "seniorTo15to64PerPersonRatio": 3.90969563647109, "sourceId": "nhiHistorical", "evidence": "derived_from_rounded_official_tables" }, { "year": 2014, "insuredByAge": [ 3210000, 4900000, 5940000, 6790000, 2770000 ], "medicalPointsByAge": [ 42800000000, 48000000000, 92900000000, 216200000000, 215400000000 ], "seniorPointsShare": 0.3500731350560702, "seniorTo15to64PerPersonRatio": 3.8390908714099847, "sourceId": "nhiHistorical", "evidence": "derived_from_rounded_official_tables" }, { "year": 2015, "insuredByAge": [ 3130000, 4880000, 5940000, 6890000, 2900000 ], "medicalPointsByAge": [ 41200000000, 49200000000, 94200000000, 221500000000, 224400000000 ], "seniorPointsShare": 0.35590800951625695, "seniorTo15to64PerPersonRatio": 3.7555154458944817, "sourceId": "nhiHistorical", "evidence": "derived_from_rounded_official_tables" }, { "year": 2016, "insuredByAge": [ 3080000, 4850000, 5890000, 6930000, 3060000 ], "medicalPointsByAge": [ 43000000000, 49500000000, 96700000000, 230900000000, 241900000000 ], "seniorPointsShare": 0.36540785498489425, "seniorTo15to64PerPersonRatio": 3.7042002693413614, "sourceId": "nhiHistorical", "evidence": "derived_from_rounded_official_tables" }, { "year": 2017, "insuredByAge": [ 3030000, 4790000, 5870000, 6970000, 3220000 ], "medicalPointsByAge": [ 43700000000, 50800000000, 101100000000, 243900000000, 261300000000 ], "seniorPointsShare": 0.3728595890410959, "seniorTo15to64PerPersonRatio": 3.6145984702732736, "sourceId": "nhiHistorical", "evidence": "derived_from_rounded_official_tables" }, { "year": 2018, "insuredByAge": [ 2990000, 4690000, 5880000, 7010000, 3380000 ], "medicalPointsByAge": [ 46000000000, 51400000000, 104600000000, 254600000000, 281900000000 ], "seniorPointsShare": 0.38171970209884903, "seniorTo15to64PerPersonRatio": 3.5709050401058344, "sourceId": "nhiHistorical", "evidence": "derived_from_rounded_official_tables" }, { "year": 2019, "insuredByAge": [ 2960000, 4610000, 5860000, 7040000, 3550000 ], "medicalPointsByAge": [ 47400000000, 52200000000, 108800000000, 265400000000, 299600000000 ], "seniorPointsShare": 0.3873803982415309, "seniorTo15to64PerPersonRatio": 3.465631688819597, "sourceId": "nhiHistorical", "evidence": "derived_from_rounded_official_tables" }, { "year": 2020, "insuredByAge": [ 2910000, 4470000, 5830000, 7050000, 3730000 ], "medicalPointsByAge": [ 42000000000, 51300000000, 108700000000, 268000000000, 310300000000 ], "seniorPointsShare": 0.39766756375752915, "seniorTo15to64PerPersonRatio": 3.3723190348525467, "sourceId": "nhiHistorical", "evidence": "derived_from_rounded_official_tables" }, { "year": 2021, "insuredByAge": [ 2850000, 4320000, 5700000, 7100000, 3890000 ], "medicalPointsByAge": [ 36000000000, 49100000000, 105100000000, 269500000000, 324500000000 ], "seniorPointsShare": 0.41379750063759246, "seniorTo15to64PerPersonRatio": 3.370624678056514, "sourceId": "nhiHistorical", "evidence": "derived_from_rounded_official_tables" }, { "year": 2022, "insuredByAge": [ 2780000, 4210000, 5630000, 7130000, 4040000 ], "medicalPointsByAge": [ 40800000000, 50500000000, 108800000000, 280800000000, 342000000000 ], "seniorPointsShare": 0.41560335399197956, "seniorTo15to64PerPersonRatio": 3.2641883820283866, "sourceId": "nhiHistorical", "evidence": "derived_from_rounded_official_tables" }, { "year": 2023, "insuredByAge": [ 2740000, 4100000, 5610000, 7200000, 4230000 ], "medicalPointsByAge": [ 52000000000, 52900000000, 113100000000, 296300000000, 371800000000 ], "seniorPointsShare": 0.41959146823157656, "seniorTo15to64PerPersonRatio": 3.215057409018225, "sourceId": "nhiHistorical", "evidence": "derived_from_rounded_official_tables" } ], "method": "全年門住診申報點數除以同年年底納保人數；不是按年度平均暴露人口計的官方人均費用。2024採18個年齡組，85歲以上合併。組內以相同人均率套用單歲人口，這是模型假設。", "limitations": [ "點數含部分負擔，不等於健保實付金額；不是醫療效率或浪費指標。", "納保人口含非戶籍人口等，與內政部戶籍人口口徑不同；套用戶籍人口推估只作相對需求指數。", "20~24歲率套用22~24歲，不能稱22歲切點的官方醫療統計。", "2025按年齡完整官方統計未取得；2024是本次核實可取得之最新完整年齡資料。", "歷年比率以官方四捨五入資料推算，宜顯示兩位小數。" ] }, "finance": { "accountingBasis": "accrual", "annual": [ { "year": 2021, "premiumRevenueBillion": 699.4689999999999, "medicalBenefitsBillion": 727.015, "badDebtBillion": 5.43, "otherNetIncomeBillion": 17.461000000000002, "netReserveAdditionBillion": -15.515, "reserveBillion": 93.62100000000001, "reserveMonths": 1.55, "sourceId": "nhiFinanceAug2026", "date": "2021-12-31", "unit": "十億新臺幣（reserveMonths為月）", "evidence": "official_audited_observation" }, { "year": 2022, "premiumRevenueBillion": 747.904, "medicalBenefitsBillion": 748.6479999999999, "badDebtBillion": 5.337, "otherNetIncomeBillion": 17.354, "netReserveAdditionBillion": 11.273, "reserveBillion": 104.894, "reserveMonths": 1.68, "sourceId": "nhiFinanceAug2026", "date": "2022-12-31", "unit": "十億新臺幣（reserveMonths為月）", "evidence": "official_audited_observation" }, { "year": 2023, "premiumRevenueBillion": 773.534, "medicalBenefitsBillion": 776.64, "badDebtBillion": 5.237, "otherNetIncomeBillion": 42.214, "netReserveAdditionBillion": 33.872, "reserveBillion": 138.76600000000002, "reserveMonths": 2.14, "sourceId": "nhiFinanceAug2026", "date": "2023-12-31", "unit": "十億新臺幣（reserveMonths為月）", "evidence": "official_audited_observation" }, { "year": 2024, "premiumRevenueBillion": 800.3489999999999, "medicalBenefitsBillion": 810.527, "badDebtBillion": 5.149, "otherNetIncomeBillion": 38.729, "netReserveAdditionBillion": 23.402, "reserveBillion": 162.168, "reserveMonths": 2.4, "sourceId": "nhiFinanceAug2026", "date": "2024-12-31", "unit": "十億新臺幣（reserveMonths為月）", "evidence": "official_audited_observation" }, { "year": 2025, "premiumRevenueBillion": 862.604, "medicalBenefitsBillion": 832.5, "badDebtBillion": 5.154999999999999, "otherNetIncomeBillion": 21.869999999999997, "netReserveAdditionBillion": 46.819, "reserveBillion": 208.987, "reserveMonths": 3.01, "sourceId": "nhiFinanceAug2026", "date": "2025-12-31", "unit": "十億新臺幣（reserveMonths為月）", "evidence": "official_audited_observation" } ], "latestReserve": { "value": 209.457520681, "unit": "十億新臺幣", "sourceId": "nhiFinanceSep2026", "date": "2026-09-30", "evidence": "official_observation", "note": "月報平衡表安全準備，非現金資產或年度預測；作情境起點不代表2026年底實際值。" }, "lastPublishedReserveMonths": { "value": 2.84, "unit": "月", "sourceId": "nhiFinanceAug2026", "date": "2026-08-31", "evidence": "official_observation", "note": "只對應當時210.034十億元；不得貼為9月底準備月數。" }, "latestAugustReserve": { "value": 210.034, "unit": "十億新臺幣", "sourceId": "nhiFinanceAug2026", "date": "2026-08-31", "evidence": "official_observation" }, "calibration": { "year": 2025, "date": "2025-12-31", "sourceId": "nhiFinanceAug2026", "evidence": "derived_from_audited_observation", "unit": "十億新臺幣／年", "totalRevenueBillion": 884.474, "totalExpenseBillion": 837.655, "medicalBenefitsBillion": 832.5, "badDebtBillion": 5.155, "premiumRevenueBillion": 862.604, "otherNetIncomeBillion": 21.87, "netReserveAdditionBillion": 46.819, "revenueLabel": "可用淨收入（保費＋其他淨收支）", "expenseLabel": "給付與呆帳", "note": "其他收支已扣部分費用，故這是保留準備金恆等式的合併淨額；不是財報gross總收入與gross總費用。準備變動=862.604+21.870−832.500−5.155=46.819。" }, "ytdAugust": { "date": "2026-08-31", "premiumRevenueBillion": 592.192, "medicalBenefitsBillion": 601.723, "badDebtBillion": 3.898, "otherNetIncomeBillion": 14.476, "netReserveAdditionBillion": 1.046, "sourceId": "nhiFinanceAug2026", "unit": "十億新臺幣", "evidence": "official_observation", "note": "1~8月累計，不直接乘1.5當全年；12月底36%差額調整可能影響季節性。" }, "defaultModelRule": "以完整2025審定流量作尺度、2026年9月安全準備作存量起點。固定淨收入年增3%、給付預算年增4%延伸原收支趨勢，兩政策共用；這是模型假設，非法定成長率，不代表已安排新補助財源。需求增加不自動提高給付。", "thresholdNote": "低於1個月或耗盡為條件式情境指標，非破產日期。原收支路徑與照護排擠路徑分開呈現；準備金只扣除累計健保撥補減少，醫療給付路徑同額減少資金與支出，護理支持另列，不把補助承諾重複列為醫療支出。", "official2026Forecast": { "medicalTotalBillion": 988.335, "premiumRatePercent": 5.17, "netBalanceBillion": -42.8, "yearEndReserveBillion": 165.1, "yearEndReserveMonths": 2.16, "unit": "十億新臺幣（比率及月數另列）", "date": "2026-01-20核定後的2026年度預估", "sourceId": "nhi2026ApprovedForecast", "evidence": "official_forecast", "note": "保留為有日期及條件的官方對照。未覆寫2026-09-30實際月報安全準備209.457520681十億元，兩者日期與性質不同。" } }, "assumptions": { "healthMultiplier": { "value": 1, "unit": "倍", "sourceId": "assumptions", "date": "2026-10-17", "evidence": "user_adjustable_assumption", "note": "只影響22~64歲的醫療需求，基準1，不作因果估計，不按年累乘。" }, "medicalAgeRateWithinBand": "每個五歲組內以同一人均點數率套用單歲人口；85歲以上同率。", "futureEligibilityShare": "可先固定403/485，但所得／稅制及既有補助覆蓋變動未建模。", "growthParametersEvidence": "原收支延伸固定採淨收入年增3%、給付預算年增4%，為固定模型假設，非現行法定比例或已核定未來預算。醫療單價年增預設3%，仍為可調探索假設。歷史成長率不直接視為未來預測。", "cashScaling": "先以基準年總保險給付校準需求指數，再按相對年齡結構、單價假設及倍率推情境；不是假定一點等於一元。", "fixedContinuation": { "revenueGrowth": 3, "budgetGrowth": 4, "unit": "%／年", "sourceId": "assumptions", "evidence": "fixed_model_assumption", "note": "兩政策共用原收支趨勢；未自行增設稅收、借款或更改給付制度。可另設照護資源擠壓比例進行風險敏感度試算，預設3%（探索假設）。" }, "centralObligation": "中央年度新增需求等於補助總額扣除選定的既有中央補助。累計需求從2027年起加總完整年度；未指定新增財源不等於已欠付，不把全部需求當成國債。", "nhiCashImpact": "保費改由政府負擔本身不新增醫療費。照護排擠預設3%，依權重分為健保撥補、醫療給付及護理支持三路徑，同筆預算只分配一次。這是推估假設，不是已發生的撥款結果；36%法定負擔未另作抵減，實際現金差額仍未知。" }, "wageReference": { "year": 2025, "annualTotal": 760632, "unit": "新臺幣／受僱員工年", "evidence": "official_observation", "sourceId": "annualWage2025", "scope": "工業及服務業全體受僱員工，含本外國籍、全時及部分工時；含獎金與加班費。與模型全體就業人口範圍不同。", "projectionRule": "2026以2025全年平均作參考起點；依同版2020~2025全年總薪資CAGR約3.1511%，預設名目年增3.2%作未來探索假設，可調整；非官方預測。" }, "illustrationAssumptions": { "workerBase": 35, "medicBase": 64, "otherBases": { "student": 20, "family": 45, "senior": 15, "chronic": 50 }, "unit": "情境壓力指標（0~100），屬情境模型，非心理或醫學量表", "incomeRule": "在職角色的既有壓力等於角色起點，乘以當年既有醫療等額支撐/當年參考年薪相對固定2026參考值的比率。參考值使用退休65歲的2026模擬就業人口及年薪760,632元。政策新增年分攤除以當年參考年薪計算政策增量，每1個百分點增加10分；兩分量保留未截斷原始值，角色顯示限制0~100。等額醫療支撐不是個人實繳保費，不與新增補助相加成總醫療成本。", "cascadeRule": "支付與照護壓力依模型逐年傳導，人口及既有負擔與政策增量分列。受照護者跨入85可由較早的主要支付者過載、持續醫護過載後的量能減損或需求遞延、或當年預算路徑的額外服務缺口觸發。各路徑取較高值，不重複加總；照護短缺亦影響在職角色。模型不推算個人疾病或死亡，角色退休不重設全系統量能回饋。", "medicRule": "醫護起始64為模型參照；以2019單院研究職業壓力68.86作量級參考，依86.8%人力反解負荷前起點約64，預設起始工作量指標約68.75。樣本與量表不同，不是全國疲勞實測或經驗證換算。在職醫護納入既有支撐相對薪資及政策新增分攤，並與動態照護負荷、需求給付及財源壓力取較高值；達85後須連續兩年原始值不超過80才解除過載。" }, "fiscalCareReference": { "centralBudget2027": { "revenueBillion": 3926.6, "expenditureBillion": 3926.6, "balanceBillion": 0, "unit": "十億新臺幣", "date": "2027年度預算案", "sourceId": "centralBudget2027Draft", "evidence": "official_budget_proposal", "note": "收支平衡表示已編列用途與收入相等，不代表國庫無現金、不能借款或不能調整預算。模型以新增需求占此歲出之比率比較量級，不據此宣稱政府必然無法支付。" }, "nhiSupport2027": { "value": 60, "unit": "十億新臺幣／年", "date": "2027年度預算案", "sourceId": "centralBudget2027Draft", "evidence": "official_budget_proposal", "note": "600億元健保基金撥補預算案作健保撥補路徑的年度上限尺度。不是本次補助專屬財源；未再次加進模型原收入，亦未認定已實際撥付。" }, "centralSupplement2026": { "revenueBillion": 3547.1, "expenditureBillion": 3594.6, "deficitBillion": 47.5, "financingIncludingRepaymentBillion": 208.5, "unit": "十億新臺幣", "date": "2026-09-03", "sourceId": "centralSupplement2026Draft", "evidence": "official_budget_proposal", "note": "追加預算案的規劃數，非年度實際赤字；不自動延伸成後續各年赤字。" }, "centralDebtAug2026": { "value": 22.5, "unit": "%", "date": "2026-08-31", "sourceId": "centralDebtAug2026", "evidence": "official_observation", "note": "中央政府1年以上公共債務未償餘額占前3年度名目GDP平均數。顯示不能僅因新增補助未指定財源，就斷言政府無支付能力。" }, "designatedNewFunding": { "value": 0, "unit": "十億新臺幣／年", "sourceId": "assumptions", "evidence": "fixed_model_assumption", "note": "本情境不自行增設本次修法專屬稅收或配套財源。0不代表政府現金、稅收、總預算或借款能力為0。" }, "careCrowding": { "default": 3, "min": 0, "max": 100, "unit": "%", "sourceId": "assumptions", "evidence": "user_adjustable_assumption", "note": "假設全社會新增公共財源需求中，有多少比例對既有照護資源形成排擠；預設3%為探索假設，非已發生事實或官方估計。年度排擠總額先以新增需求×比例計算，再分至健保撥補、醫療給付與護理支持三路徑，各自適用上限；自2027年起作用。同一筆額度不重複扣除，未分配或超過上限的部分不自動轉分其他路徑。" }, "reserveStressRule": "受擠壓情境準備=原收支情境準備−2027年起累計健保撥補路徑減額；不減去三路徑總額。醫療給付路徑同時調整收入與給付，護理支持路徑採獨立外部預算邊界；同一筆公共責任只分配一次。600億元參考額不再加進原收入，也不作36%法定負擔抵減。", "accountingBoundary": "介面可將中央與健保合看公共財務風險；內部仍區分中央補助承諾、家庭保費替代與健保基金資金，不將不同帳務項目重複加總。", "nursingSupport2026": { "value": 6.66, "nightShiftBillion": 4.7, "ratioAchievementBillion": 1.6, "mentorshipBillion": 0.36, "unit": "十億新臺幣／年", "date": "2026-05-08公布的年度計畫經費", "sourceId": "nursingEnvironment2026", "evidence": "official_program_budget", "note": "66.6億元為三項計畫合計，作護理支持路徑的年度上限尺度與新增財源需求的量級比較。不是新補助已確定削減的經費，不直接等同可被挪用的財源，亦不重複計入另一筆健保25億元投入。" }, "nurseStaffing": { "default": 86.8, "unit": "%", "published": "2026-08", "sourceId": "nursingStaffingStudy2026", "evidence": "survey_sample", "sample": { "nursingSupervisors": 207, "nurses": 680 }, "standardDeviationPercentagePoints": 22.4, "scope": "受訪醫院實際護理人力占三班護病比最低所需人力平均比率；非全國普查。", "projectionRule": "將樣本比率作可調情境起點；後續人力會依持續過載後的減損假設與當年護理支持因子變化，服務量另受財源限制。這些動態延伸不是官方護理人力預測；未另建招募、回流與技術改善路徑。", "note": "出版日期不代表調查日期；摘要未載實際問卷收集年份。" }, "careCapacityRule": "新照護需求量比=當年年齡加權點數需求（含健康倍率）÷2026基準需求，不含醫療單價成長。初始服務量能=nurseStaffing/86.8；人力量能=初始服務量能×累積保留人力×當年護理支持因子，財源量能=初始服務量能×當年服務資源因子；可用量能取兩者較小值，不把重疊限制相乘。當年待處理量=新需求+上年保留量；服務量=min(待處理量,可用量能)，超出量能比=未服務量/待處理量。工作負荷另以待處理量÷(nurseStaffing/100×累積保留人力×護理支持因子)計算。均為模型資源量，不是全國實測未就醫比例；86.8%不直接代表2026年有13.2%的病人未獲服務。", "carePathways": { "evidence": "user_adjustable_assumption", "sourceId": "assumptions", "startYear": 2027, "defaultWeights": { "nhi": 1, "medical": 1, "nursing": 1 }, "nursingCapacityResponsePercent": 25, "statutoryContributionOffsetBillion": 0, "allocationRule": "排擠總額依三路徑非負權重的相對比例分配；全部權重為0時不分配。健保撥補上限60十億元，醫療給付上限為當年計畫給付，護理支持上限6.66十億元。上限參考與未來固定延伸不是核定可刪減預算。", "accountingRule": "健保撥補減額只降低基金收入並累積影響準備；醫療給付減額同時降低當年收入及計畫給付，不再重複減準備；護理支持視為獨立外部預算的模型邊界，不另扣基金收入或準備。未採36%法定負擔抵減。", "capacityRule": "可支應服務量以當年收入與正值期初準備為限，與相同基線比較得服務資源因子；護理支持因子=1−(護理支持減額/6.66十億元)×反應係數。預設反應係數25%為可調假設，只影響當年量能水準，不逐年複利。", "limitation": "權重、排擠比例、支持轉量能係數及外部預算邊界均為情境假設，未由本政策的因果研究校準。預算案與計畫參考額不代表已受排擠或可任意挪用。" }, "careFeedback": { "evidence": "user_adjustable_assumption", "sourceId": "assumptions", "defaultEnabled": true, "defaultAnnualAttritionPercent": 3, "defaultBacklogCarryPercent": 50, "criticalPressure": 85, "consecutiveYears": 2, "attritionRule": "醫護群體未封頂壓力連續兩年達85後，從翌年依設定比例減少保留人力；保留人力逐年承接前期，關閉回饋時不套用此減損。85與兩年均為模型條件，非醫學診斷。", "backlogRule": "當年新照護需求加上前期積壓，扣除可提供服務量後，未完成量按保留比例帶入翌年；關閉回饋時不跨年保留。這是資源加權量，不是人數、病情惡化率或所有醫療可安全延期的比例。", "pressureRule": "醫護群體壓力同時參考醫療工作量、資源限制與既有支撐及新增分攤相對薪資；財務分攤轉壓力、再轉人力減損的關係是團隊設定的探索機制，並非本政策的實證因果效果。即使排擠設為0，其他壓力與照護回饋仍可作用。", "limitation": "預設3%／50%屬嚴峻敏感度設定，不是最可能情境、機率或研究預測。三組情境只提供假設對照，未涵蓋所有未來改善與惡化路徑。" } } }