溫室氣體淨零排放為攸關國家永續發展之重大議題，甫經修訂之《氣候變遷因應法》已明定我國需於 2050 年前達成此目標。面對氣候變遷對國民健康的衝擊，醫療部門雖為照護關鍵要角，然其本身亦占我國溫室氣體總排放量4.6%，更居「非生產性質行業」能源消費之首位。針對此一溫室氣體減量與醫療照護治理難題，本論文運用新制度主義（ New Institutionalism）之研究途徑，深度剖析英國、美國與歐盟等先行個案之轉型策略，並歸納出「國家行政主導型」（英國）、「市場誘因驅動型」（美國）與「 規範引導與側面規制型」（歐盟）三種治理模式。

本論文發現，醫療部門淨零路徑高度依賴於各國既有制度脈絡與治理邏輯，而我國醫療體系則呈現獨特的「單一支付者（全民健保）」與「高度管制下市場導向供給」混合特質。 因此，本論文提出「國家－市場混合型」治理模式建議， 主張政府應善用健保給付與評鑑制度的行政槓桿， 並結合綠色金融和供應鏈的協同治理，建構一套具備強制力與誘因機制的複合式轉型路徑，穩健推進我國 2050 年淨零排放目標。

Climate change constitutes a critical global health emergency, yet the healthcare sector itself acts as a significant contributor to the crisis. In Taiwan, the healthcare sector accounts for approximately 4.6% of national greenhouse gas emissions. With the legal mandate to achieve Net-Zero by 2050, the sector faces an urgent imperative to decarbonize. This study addresses the complex governance challenge of healthcare decarbonization by adopting a comprehensive New Institutionalism framework. Integrating Historical, Rational Choice, and Sociological Institutionalism, the research analyzes the governance logics of three pioneering cases: the United Kingdom (UK), the United States (US), and the European Union (EU).

The comparative analysis identifies three distinct models rooted in their respective institutional contexts. The UK employs a "State-Administrative Dominant Model," leveraging the National Health Service’s vertical authority and monopsonistic power to enforce statutory Net-Zero duties. The US adopts a "Market-Incentivized Model," where the federal government utilizes tax credits (Inflation Reduction Act) and transaction-cost-reducing contracts to steer a fragmented private market. The EU demonstrates a "Norm-Guided and Indirect Regulation Model," overcoming the "Principle of Subsidiarity" constraints through lateral legislative standards in energy and products, combined with NGO-driven normative pressure.

The study concludes that successful strategies must align with domestic institutional endowments. Consequently, a "State-Market Hybrid Model" is proposed for Taiwan, recommending the synergy of the National Health Insurance’s administrative leverage, market-based incentives, and ethical normative construction to achieve a sustainable Net-Zero transition.

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三、研討會文章
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四、政府文件
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經濟部，2022，《2022非生產性質行業能源查核年報》
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British Medical Association. 2024. “More support needed to help the NHS reach net zero.” https://www.bma.org.uk/what-we-do/population-health/protecting-people-from-threats-to-health/more-support-needed-to-help-the-nhs-reach-net-zero (Accessed 2024/09/14)
Open Access Government. 2023. “Decarbonising the NHS Estate in 2023.” https://www.openaccessgovernment.org/decarbonising-the-nhs-estate-2023-carbon-emissions-eon/155327/ (Accessed 2024/09/14)
The New York Times. 2017. “Trump Will Withdraw U.S. From Paris Climate Agreement.” https://www.nytimes.com/2017/06/01/climate/trump-paris-climate-agreement.html (Accessed 2024/05/02)
Harvard Law School. 2021. “Biden’s First 100 Days of Climate Action.” https://eelp.law.harvard.edu/wp-content/uploads/Bidens-First-100-Days-FINAL.pdf (Accessed 2024/05/03)
National Academy of Medicine. 2022. “Action Collaborative on Decarbonizing the U.S. Health Sector Virtual Meeting.” https://nam.edu/event/action-collaborative-on-decarbonizing-the-u-s-health-sector-virtual-meeting-2/ (Accessed 2024/05/10)
National Academy of Medicine. 2023. “How Health Care Organizations Can Use the Inflation Reduction Act to Reduce Costs, Enhance Resilience, and Lower Their Environmental Footprint https://nam.edu/wp-content/uploads/2023/11/How-Health-Care-Organizations-Can-Use-the-Inflation-Reduction-Act-to-Reduce-Costs-Enhance-Resili.pdf (Accessed 2024/05/10)
Bipartisan Policy Center. 2023. “Cleaner Health Care_Hospital Emission Mitigation” https://bipartisanpolicy.org/report/cleaner-health-care-hospital-emissions-mitigation/ (Accessed 2024/05/15)
Georgetown Climate Center. 2023. “Decarbonizing Health Care: Clean Energy Policy Options”https://www.georgetownclimate.org/files/report/Decarbonizing_Health_Care_Clean_Energy_Policy_Options.pdf (Accessed 2024/05/19)
Washington State Hospital Association. 2022. “New clean buildings standard: start planning for compliance.” https://www.wsha.org/articles/new-clean-buildings-standard-start-planning-forcompliance/ (Accessed 2023/12/18)
National Academy of Medicine. 2024. “The Action Collaborative on Decarbonizing the U.S. Health Sector.” https://nam.edu/programs/climate-change-and-human-health/action-collaborative-on-decarbonizing-the-u-s-health-sector/ (Accessed 2024/05/19)
National Academy of Medicine. 2020. “Action Required: Climate Change Poses Dire Threats to Global Health and Well-Being.” https://nam.edu/news-and-insights/action-required-climate-change-poses-dire-threats-to-global-health-and-well-being/ (Accessed 2024/05/21)
The Joint Commission. 2023. “The Joint Commission announces Sustainable Healthcare Certification for U.S. hospitals.” https://www.jointcommission.org/resources/news-and-multimedia/news/2023/09/sustainable-healthcare-certification-for-us-hospitals/ (Accessed 2024/05/24)
American Society of Heating, Refrigerating, and Air-Condition Engineers. 2024. “Series of Guidebooks.” https://www.ashrae.org/about/tfbd-upcoming-guides (Accessed 2024/05/24)
2022, “Letter from Michael Sheerin, Chair ASHRAE Standing Standard Project Committee 170, to Arsenio Mataka, Senior Advisor for Climate and Health Equity, Office of Climate Change and Health Equity, Department of Health and Human Services” (Accessed 2024/05/25)
Price Industries. 2022. “How Is ASHRAE Standard 170 Applied to Hospital Operating Rooms?” https://blog.priceindustries.com/how-is-ashrae-standard-170-applied-to-hospital-operating-rooms# (Accessed 2024/05/25)
American Society for Health Care Engineering and American Hospital Association, “Should Evaluate and Implement Operating Room Airflow Setback” https://www.ashe.org/system/files/media/file/2020/11/12_Evaluate_and_Implement_OR_Airflow_Setback%20%281%29.pdf (Accessed 2024/05/25)
Health Facilities Management Magazine. 2018. “Studying airflow in the OR.” https://www.hfmmagazine.com/articles/3246-studying-airflow-in-the-or#:~:text=Due%20to%20variations%20in%20 (Accessed 2024/05/25)
The American Society for Health Care Engineering. 2024. “Decarbonizing Health Care Facilities.” https://www.ashe.org/sustainability/decarbonization (Accessed 2024/05/28)
Billion Dollar Green Challenge. 2016. “Cleveland Clinic.” https://greenbillion.org/participant/clevelandclinic/ (Accessed 2024/05/29)
Billion Dollar Green Challenge. 2016. “Grady Health System.” https://greenbillion.org/participant/grady/ (Accessed 2024/05/29)
Billion Dollar Green Challenge. 2014. “Bon Secours Health System.” https://greenbillion.org/participant/bon-secours-health-system/ (Accessed 2024/05/29)
Harvard Business Review. 2019. “How Health Systems Are Meeting the Challenge of Climate Change.” https://hbr.org/2019/09/how-health-systems-are-meeting-the-challenge-of-climate-change (Accessed 2024/05/30)
Pfizer, “Environmental Sustainability.” https://www.pfizer.com/about/responsibility/environmental-sustainability (Accessed 2024/05/30)
American College of Physicians. 2023. “Toolkit: Climate Change and Health” https://www.acponline.org/advocacy/advocacy-in-action/toolkit-climate-change-and-health (Accessed 2024/05/31)
Medical Society Consortium on Climate & Health. “Consensus Statement.” https://medsocietiesforclimatehealth.org/mission-consensus-statement/ (Accessed 2024/05/31)
Practice Greenhealth. 2024. “Health Care Emissions Impact Calculator.” https://practicegreenhealth.org/tools-and-resources/health-care-emissions-impact-calculator (Accessed 2024/05/31)
National Academy of Medicine. 2023. “Carbon Accounting 101” https://nam.edu/programs/climate-change-and-human-health/action-collaborative-on-decarbonizing-the-u-s-health-sector/carbon-accounting-101/ (Accessed 2024/05/31)
New York University- Stern School of Business. “Return on Sustainability Investment (ROSI™) Methodology.” https://www.stern.nyu.edu/experience-stern/about/departments-centers-initiatives/centers-of-research/center-sustainable-business/research/return-sustainability-investment-rosi (Accessed 2024/05/31)
The Commonwealth Fund. 2022. “The business case for decarbonization of health care systems.” https://www.commonwealthfund.org/grants/business-case-decarbonization-health-caresystems (Accessed 2024/05/31)
Fitch Ratings. 2024. “Operating Margins Reset a Potential ‘Pain Point’ for U.S. NFP Hospitals.” https://www.fitchratings.com/research/us-public-finance/operating-margins-reset-potential-pain-point-for-us-nfp-hospitals-29-01-2024?ite=1055569&ito=2639&itq=830bbef9-6a48-4bdc-a0f0-058bbe8ad808&itx%5Bidio%5D=139430645 (Accessed 2024/06/03)
Encore Renewable Energy. “Encore Renewable Energy Announces Completion of UVM Medical Center Solar Rooftop.” https://encorerenewableenergy.com/encore-renewable-energy-announces-completion-of-uvm-medical-center-solar-rooftop/ (Accessed 2024/06/09)
Association of American Medical Colleges. 2019. “Hospitals race to save patients — and the planet.” https://www.aamc.org/news/hospitals-race-save-patients-and-planet (Accessed 2024/06/09)
U.S. Green Building Council. 2023. “Turning the health care sector toward decarbonization.” https://www.usgbc.org/articles/turning-health-care-sector-toward-decarbonization (Accessed 2024/06/03)
Reuters. 2021. “New York City Bans Natural Gas in New Buildings.” https://www.reuters.com/markets/us/new-york-city-set-ban-natural-gas-new-buildings-2021-12-15/#:~:text=The%20law%20would%20apply%20to,hospitals%2C%20commercial%20kitchens%20and%20laundromats. (Accessed 2024/06/07)
WGBH News. 2022. “Boston Moves to Ban Fossil Fuels in New Construction.” https://www.wgbh.org/news/politics/2022-09-14/boston-moves-to-ban-fossil-fuels-in-new-construction (Accessed 2024/06/07)
American Council for an Energy-Efficient Economy. 2020. “Electrifying Space Heating in Existing Commercial Buildings: Opportunities and Challenges.” https://www.aceee.org/sites/default/files/pdfs/b2004.pdf (Accessed 2024/06/10)
The New York Times, 2023, “Wind and Solar Energy Projects Risk Overwhelming America’s Antiquated Electrical Grids” https://www.nytimes.com/2023/02/23/climate/renewable-energy-us-electrical-grid.html?smid=nytcore-ios-share&referringSource=articleShare (Accessed 2024/06/07)
Jenkins, J.D., et al., “Electricity Transmission is Key to Unlock the Full Potential of the Inflation Reduction Act.” https://repeatproject.org/docs/REPEAT_IRA_Transmission_2022-09-22.pdf (Accessed 2024/06/07)
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World Health Organization. “Alliance for Transformative Action on Climate and Health- Commitments.” https://www.who.int/initiatives/alliance-for-transformative-action-on-climate-and-health/commitments (Accessed 2024/09/28)
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KLIK green., “KLIK green- Hospitals meet Climate Protection.” https://www.klik-krankenhaus.de/project-description (Accessed 2024/09/29)
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Green Deal Duurzame Zorg. “Green Deal Healthcare Results.” https://www.greendealduurzamezorg.nl/resultaten/ (Accessed 2024/10/02)
Health Care Without Harm (Europe). “The Carbon management mentoring programme.” https://europe.noharm.org/climate-smart-healthcare/carbon-management-mentoring-programme-previous-editions (Accessed 2024/09/29)
Health Care Without Harm (Europe). “Climate-smart Healthcare training: Healthcare professionals driving decarbonization.” https://europe.noharm.org/events/climate-smart-healthcare-training-healthcare-professionals-driving-decarbonisation (Accessed 2024/09/29)
Health Care Without Harm (Europe). “Race to Zero and the Health Care Climate Challenge.” https://europe.noharm.org/race-zero-and-health-care-climate-challenge (Accessed 2024/09/29)
Health Care Without Harm (Europe). “Doctors for Greener Healthcare.” https://europe.noharm.org/join-our-networks/doctors-greener-healthcare (Accessed 2024/10/01)
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Partnership for Health System Sustainability and Resilience & London School of Economics and Political Science. 2022. “Sustainability and Resilience in the Portuguese Health System.” https://www3.weforum.org/docs/WEF_PHSSR_Portugal_2022.pdf (Accessed 2024/10/05)
Health Care Without Harm. 2021. “Health Sector Emissions Fact Sheet – Portugal.” https://healthcareclimateaction.org/fact-sheets/en/English%20-%20Portugal (Accessed 2024/10/05)
RTE (Raidió Teilifís Éireann). 2024. “Largest surge in HSE staff numbers last year, health committee told.” https://www.rte.ie/news/politics/2024/0320/1438925-health-committee/ (Accessed 2024/10/08)
FALCK. 2023. “Falck launches its first electric ambulance.” https://www.falck.com/news/latest-news/falck-launches-its-first-electric-ambulance/ (Accessed 2024/10/22)
WAS. “WAS 500 E-RTW in regular rescue service.” https://www.was-vehicles.com/en/news/first-fully-electric-ambulance-for-the-regular-rescue-service-in-cologne (Accessed 2024/10/22)
Ford News Europe Blog. 2023. “Paramedics praise pioneering E-Transit ambulance.” https://fordeurope.blogspot.com/2023/10/electric-transit-ambulance-in-valenica-spain-parmedics-transvia-med.html (Accessed 2024/10/22)
NetZeroAICT. “About.” https://netzeroaict.eu/about/ (Accessed 2024/10/18)
Health Care Without Harm Europe. 2025. “Policy Brief: Charting a Course to Net Zero Emissions for the European Healthcare Sector.” https://eue.noharm.org/media/7092/download?inline=1 (Accessed 2025/10/03)
Eurocities. “Covenant of Mayors.” https://eurocities.eu/projects/covenant-of-mayors/ (Accessed 2024/09/21)
六、網路資料庫
（一）中文
全國法規資料庫，〈氣候變遷因應法 〉 https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=O0020098 （檢索日期2023/10/06）
全國法規資料庫，〈醫療法〉https://law.moj.gov.tw/LawClass/LawAll.aspx?pcode=L0020021（檢索日期2025/12/08）
（二）英文
Net Zero Tracker. “DATA EXPLORER” https://zerotracker.net/#data-explorer (Accessed 2023/07/23)