社區醫療的式微，造成民眾就醫可近性低、城鄉差異大；分科過細民眾接受到分割化的照顧。1999年921大地震除造成台灣居民性命與財產的重大損傷外，更凸顯出台灣醫療體系在社區的問題。這包括了：缺乏統籌的醫療資源整合系統、缺少醫療與救災單位的合作默契、通報指揮派遣等機制的不健全、人力物資後援管道不足、缺乏照護轉介服務系統、不注重預防保健服務、缺乏醫護人員繼續教育或經驗交換的管道。因此台大醫學院與台灣家庭醫學會提出『社區醫療群』的構想，期待重新重視基層醫療的功能，改善不良的醫療體系，並重新建立以民眾、家庭、及社區為中心的持續性與完整性照護。

　　2003年由中央健康保險局推出『家庭醫師整合照護』試辦計畫。內容包含：5-10診所合作組成社區醫療群，1/5以上具有家庭醫師專科，並與1-2家特約醫院合作，組成區域範圍以符合社區民眾生活圈為原則。醫院提供雙向轉診資源、共同照護門診、醫學繼續教育。醫療群診所醫師以家戶為照護單位，並透過醫療資訊系統予以建檔。服務內容除一般診療外，尚須包含預防保健，如成人健檢、子宮抹片、流感注射…等服務。施行至2011年底，共有379個社區醫療群，參與診所數佔基層診所的23.37%，參與的醫師數佔基層開業醫師的18.61%，參加計畫的民眾佔總人口大約7%。

　　災害重建的經驗，讓我們能改善醫療體系的不足。台灣的家庭醫師制度，回應了WHO2008年健康報告書重視基層醫療，與以民眾為中心的醫療體系改革。2009年H1N1來襲時，各地的社區醫療群得以迅速的與地方衛生局所合作，成立發燒篩檢站、流感快篩門診，並提供克流感藥物。人民的健康得到了更好的照顧。

Abstract:
Indifference to primary healthcare resulted in rural-urban disparities and fragmented care. The 921 earthquake stroke Taiwan in 1999 not only had enormous fatalities and damages, it further exposed the drawback of health care system in the community. The problems are as below:
1. Lack of integrated system on medical resources
2. Poor cooperation between medical and rescue teams
3. Malfunction of the reporting, commenting and dispatch system
4. Shortage of human resources and material supply
5. Lack of health delivery and referral system
6. Regardless of health prevention
7. Few ways of continuous education or sharing experiences between medical professionals.
Thus, the Medical department of National Taiwan University (NTU) and Taiwan’s Association of Family Medicine (TAFM) promoted the idea of “community health care groups” (CHCG) in order to strengthen primary health care and to provide people-centered, family-based and community-oriented health care.
The “integrated care plan through CHCG” was demonstrated since 2003. A CHCG is composed of 5 to 10 GPs, in which half of them are specialized in family medicine. Each CHCG enrolled members in the neighborhood and provided them with continuous and comprehensive care, such as health promotion (24-hr consultation, screening), disease prevention (vaccination), disease care, and 2-way referral between the clinic and hospital. CHCG improved their care quality through continuous health education and survey of patients’ satisfaction. To date, there are 23.37% GPs in Taiwan participated in this project and the enrollees are around 7% nationwide.
Lessons learned from natural disasters are vital to the improvement of health care system. Taiwan’s medical reconstruction of primary care network through family doctors in CHCGs gives a very good example in response to WHO’s call for primary health care. When H1N1 endemic stroke Taiwan in 2009, the CHCGs were able to responded quickly and cooperate with local health bureau. In no time, they set up stations for fever check-up, influenza viral lab screening, and anti-viral drug prescription. Efficiently, we deliver better health to the residents in community.