背景與目的：本研究之研究目的是以公共衛生政策之介入，探討「醫學中心次專科醫師團隊的介入」對離島空中緊急醫療轉送的影響，以澎湖為研究對象。材料與方法:研究對象用回溯法(Retrospective method)將民國88年10月1日至民國94年12月1日空中緊急醫療轉 送之相關資料進行研究。研究依不同之公共衛生政策之介入分為三階段。第一階段探討澎湖地區自民國88年10月1日至民國91年的月30日空中緊急醫療轉送案例，即為全國空中緊急醫療救護諮詢中心開始審核澎湖地區案例之 前(共35個月)。第二階段以回溯法探討澎湖地區自民國91年11月1日至92年8月1日空中醫療轉送案例，即為全國空中緊急醫療救護諮詢中心開始審核澎湖地區案例及視訊系統使用之後至次專科醫師醫療團隊介入之前(共10個月)。第三階段以回溯法探討澎湖地區自民國92年9月1日至民國94年12月1日空中緊急醫療轉送案例， 以醫學中心三軍總醫院次專科醫師支援澎湖醫院為介入因子，作為第三階段的研究(共28個月)。結果：研究結果顯示平均每個月轉送航次於第一階段(35個月)平均每月申請19.6 (685/35)航次;執行19.6 (685/ 35 )航次;第二階段(10個月)平均每月申請13.7( 137110)航次;執行12.5 (125/10 )航次;到第三階段(28個月) 平均每月申請7.l5(217泣的航次;執行6.93 ( 194泣的航次，平均每月申請航次及執行航次皆有明顯下降的趨勢。 責任空域內的轉送自第一階段的74.9%升高至第二階段88.3%，到第三階段更提升至94.0%，隨機醫護人員比率高達96.7%。空中緊急醫療轉送航次的減少，第二階段比第一階段每月約節省經費142萬元，每年約可減少政府1704萬元空中醫療緊急後送的經費。空中緊急醫療轉送航次的減少，第三階段比第一階段每月約節省經費169.2萬元，每年約可減少政府2030萬元空中醫療緊急後送的經費。第三階段比第二階段每月約節省經費111.4萬元，每年約可減少政府1336.8萬元空中醫療緊急後送的經費。結論：本研究是以公共衛生政策的介入，探討介入前後空中醫療轉送的減少，使離島居民所受到的醫療照護更加完善，當地醫療水準更加提昇。此項成功的經驗可建立民眾對中央與地方醫療政策的信心，並可提供其他偏遠離島地區，如金門縣、連江縣等離島偏遠地區，作為政府制定衛生政策之參考依據。

Background: In this study, we investigate the effectiveness of the other kind of intervention that is recruiting sub-specialist physicians in reduction of patients requesting EAMT and saving of cost in remote islands. Material and Method: There were three phases in this study. Stage 3 comprises EAMT requests after the intervention of recruitment of sub-specialist physicians from September 1, 2003 to December 31, 2005. The category of specialists that were recruited is according to the disease classifications of patient who requested for EAMT services of stage 1 and stage 2. Results:1039 EAMT applications were included in this study. There were 685, 137 and 217 EAMT applications during stage one (S1), two (S2) and three (S3). Decreasing trends of requests for EAMT applications per month from 19.60 (S1), 13.70 (S2), and 7.75 (S3) were found (p =0.003). The average flights per month were also significant decreasing from 19.60 (S1), 12.50 (S2), to 6.93 (S3) respectively. The approval rate of EAMT requests in 3 stages of the study was falling from 100% (S1), 91.2% (S2), to 89.4% (S3). The majority of patients were categorized with major diseases (76.0%), trauma patients were only one fourth of the total population (24.0%). Cost savings in stage 3 resulted in an annual savings on EAMTs of US$268,122 than stage 2. The total annual savings on EAMTs (S3-S1) is US$634,359. Conclusion: Recruiting specialist physicians from main-island to remote islands associated with preflight screening and videotelemedicine systems is the best policy of EAMT reduction in remote islands and cost-effectiveness in Taiwan.