A Model for Evaluating the Efficiency of Teaching Hospitals

醫院效率評估模式之探討

王素真(Su-Chen Wang)

《Mid-Taiwan Journal of Medicine》 12卷2期 (2007/06) Pp. 83-91

https://doi.org/10.6558/MTJM.2007.12(2).3

摘要

目的　評估醫院之效率變動情形，及探討影響醫院效率變動的因素，期望建立適合評估教學醫院經營效率的模式。
方法　研究樣本有101家綜合教學醫院，採自1997、2000、2003年衛生署「醫院評鑑」及國家衛生研究院「全民健康保險資料庫」中健保業務資料。利用資料包洛分析中的投入導向模式，評估教學醫院長期效率的變動，及藉由迴歸分析探討造成各教學醫院經營無效率的原因。
結果　私立醫院高於公立醫院，醫學中心高於區域醫院，區域醫院又高於地區醫院，按權屬別細分以私立一般財團法人醫院的平均效率值為最高，最低是衛生署立醫院。迴歸分析發現，醫院病床佔床率及是否實施全面品質管理等變項，對醫院的經營效率有顯著性的正面影響：醫院所有權、服務科別數、平均住院日數、教育訓練人數、市場競爭性等五個變項，對醫院經營效率有顯著性的負面影響。
結論　效率的改善是持續性的工作，本研究希望建立適合於教學醫院評估效率的模式及探討影響其經營無效率的因素，供醫院管理者在品質管理、控制成本、科別規模等方面之參考，以提升佔床率改善生產力，獲得最大效率。

關鍵字

資料包洛分析法 ； 效率 ； 迴歸分析

並列摘要

Purpose. To construct a model for evaluating the efficiency of public and private general teaching hospitals in Taiwan.
Methods. An Input-oriented Data Envelopment Analysis model, a cross-sectional study design based on secondary data analysis, was constructed to evaluate the efficiency of 101 hospitals in the years 1997, 2000 and 2003. Factors which influenced inefficiency of hospitals were examined using regression analysis. The sources of data came from the Department of Health database on Basic Hospital Accreditation Data and the Survey of the Status and Service Quantity of Public and Private Hospitals.
Results. Private hospitals were more efficient than public hospitals; medical centers performed better than regional hospitals and district hospitals. Juridical private hospitals had the highest average efficiency score, while hospitals managed by the Department of Health had the lowest efficiency scores. Regression analysis revealed that a high occupancy rate and the quantity of total quality management programs were indicative of a well-run hospital. Five factors had a significant negative influence on hospital efficiency, namely, hospital's ownership, department, average length of stay, persons who attended teaching and training programs, and degree of competition.
Conclusions. Improving efficiency of hospitals is a continuing task requiring long-term observation and analysis. Administrators should focus on management of quality control, controlling costs, justifying scale of departments and increasing the occupancy rate of hospitals to improve efficiency.

並列關鍵字

data envelopment analysis ； efficiency ； regression analysis