考量醫護人力短缺及兼顧醫療品質之醫院經營績效評估模式－以台灣急性照護醫院為例

An Extended DEA Model for Hospital Performance Evaluation Considering Medical Manpower Shortage and Quality of Care: Taking Acute Care Hospitals in Taiwan as Examples

洪素英(Su-Ying Hung) ； 吳泰熙(Tai-Hsi Wu)

《企業管理學報》 44卷4期 (2019/12) Pp. 57-89

https://doi.org/10.3966/102596272019120444003

摘要

台灣地區之醫院績效評估過去多偏重在經營效率，顯少同時兼顧醫療品質，加上現今醫護人力短缺的問題，傳統的效率評估模型已無法符合現況。本研究應用資料包絡分析法建構兩階段評估模式：階段一建立技術效率評估模式，在現有醫護人力不可減少之限制下，求得各醫院之最佳經營效率；階段二則在階段一之基礎上，再納入醫療照護品質考量，建立綜合效率模式。本次研究之分析數據量涵蓋全國急性醫療照護之大部分數據，研究結果亦高度符合實務現況。針對效率值未臻理想之醫院，本研究提出調整病床配置、增加初診與轉診人數，並提升照護品質等建議。

關鍵字

資料包絡分析法 ； 醫院經營效率 ； 醫療品質 ； 非意欲產出 ； 不可控制投入

並列摘要

In Taiwan, hospital performance evaluations largely focus on managerial efficiency and rarely on healthcare quality, together with the growing shortage of medical professionals, the conventional performance evaluation models can thus no longer truly reflect current situation. In this context, the authors proposed a practical hospital performance evaluation method based on the data envelopment analysis. The method comprises two stages. During the first stage, a technical efficiency evaluation model was developed to calculate the optimal managerial performance of hospitals, while in the second stage, results from the first stage were incorporated into the analysis of healthcare quality to create a comprehensive efficiency model that conformed to current situations. Hospitals evaluated in this study include medical centers, regional hospitals, and district hospital; data analyzed in this study has encompassed a large portion of the acute medical care of the entire country. The research results and findings of this study accurately match the current situations. For hospitals failing to reach ideal efficiency values, suggestions for adjusting bed configuration were proposed.

並列關鍵字

Data envelopment analysis (DEA) ； Hospital managerial efficiency ； Healthcare quality ； Undesirable output ； Un-controllable input

參考文獻

林江亮、楊志春、郭弘卿 (2007)。臺灣公立醫院經營效率之實證研究。現代會計與審計，3(5)，45-52。

翁瑞萱、徐愫萱、施至遠、黃勝堅 (2015)。臺灣社區安寧居家療護之現在與未來。護理雜誌，62(2)，18-24。

高強、黃旭男 (2003)。管理績效評估─資料包絡分析法。台北市：華泰文化事業公司。

張石柱、蕭幸金、陳美惠、王詩鳳 (2008)。醫療品質與生產力變動之評估―以台灣醫療品質指標計畫 (TQIP)為例。當代會計，9(1)，1-32。

陳巧珊、程于珊、許怡欣 (2008)。運用資料包絡分析法探討署立醫院、縣市立醫院及其委託經營醫院經營效率。澄清醫護管理雜誌，4(3)，7-13。