Measuring the Efficiency of Dental Department in Medical Centers: A Nonparametric Analysis Approach

醫學中心牙科經營效率之衡量－非參數分析

王素真(Su-Chen Wang) ； 蔡吉政(Chi-Cheng Tsai) ； 黃純德(Shun-Te Huang) ； 洪玉珠(Yu-Jue Hong)

《The Kaohsiung Journal of Medical Sciences》 18卷12期 (2002/12) Pp. 610-621

https://doi.org/10.6452/KJMS.200212.0610

摘要

本研究目的在評估多家醫學中心牙科部門之經營效率。依據次級資料所設計的橫斷性研究，利用資料包絡分析法(data envelopment analysis，DEA)模式分析1999年台灣地區16家醫學中心牙科部門的相對經營效率。68.7%醫學中心的牙科部門在整體經營效率與規模效率上係屬於相對無效率；屬及相對有效率的醫院皆為私立醫學中心牙科部門(100.0%)，有50.0%的牙科部門未能充分利用醫療費源，其中有75.0%的公立醫學中心牙科部門未能充分利用醫療資源。在規模報酬方面，56.3%醫學中心牙科部門的經濟規模報酬正處於遞增的情況，即是會因規模不足而影響到醫院整體經營績效，其中公立醫學中心更是佔77.8%。整體而言，私立醫學中心牙科部門的規模較公立醫學中心牙科部門適當。另本研究藉由敏感度分析發現教學及研究負擔較重的醫院，其臨床效率表現較低。此外，就權屬別而言，公立醫學中心牙科部門的經營效率較私立醫學中心之經營效率差，附屬於醫學院之醫學中心牙科部門的經營效率值較非附屬於醫學院醫學中心牙科部門的經營效率低。本研究維持以往研究效率估計的假設，篩選同質性高的醫學中心牙科部門為研究對象，推論其同類別的投入或產出項目之差異性應是最小。由於本研究缺乏各醫院牙科部門長期資料，因此，建議未來研究者可朝向此一主題加以驗證，並可以利用不同的投入產出項，與共同的權數來進一步探討醫院牙科部門的長期性經營效率。

關鍵字

醫學中心 ； 牙科部門 ； 效率 ； 資料包絡分析法

並列摘要

Data envelopment analysis (DEA), a cross-sectional study design based on secondary data analysis, was used to evaluate the relative operational efficiency of 16 dental departments in medical centers in Taiwan in 1999. The results indicated that 68.7% of all dental departments in medical centers had poor performance in terms of overall efficiency and scale efficiency. All relatively efficient dental departments were in private medical centers. Half of these dental departments were unable to fully utilize available medical resources. 75.0% of public medical centers did not take full advantage of medical resources at their disposal. In the returns to scale, 56.3% of dental departments in medical centers exhibited increasing returns to scale, due to the insufficient scale influencing overall hospital operational efficiency. Public medical centers accounted for 77.8% of the institutions affected. The scale of dental departments in sensitivity analysis, the numbers of residents, interns, and published papers were used to assess teaching and research. Greater emphasis on teaching and research in medical centers has a large effect on the relative inefficiency of hospital operation. Dental departments in private medical centers had a higher mean overall efficiency score than those in public medical centers, and the overall efficiency of dental departments in non-university hospitals was greater than those in university hospitals. There was no information to evaluate the long-term efficiency of each dental department in all hospitals. A different combination of input and output variables, using common multipliers for efficiency value measurements in DEA, may help establish different pioneering dental departments in hospitals.

並列關鍵字

data envelopment analysis ； DEA ； efficiency ； medical center ； dental department