軍人納入全民健保後國軍醫院經營效率之探討

On Operation Efficiency of Military Hospitals after Including Military Personnel in the National Health Insurance System

張石柱(Shyr-Juh Chang) ； 蕭幸金(Shing-Chin Shiao) ； 姜美惠(Mei-Huei Chiang)

《醫務管理期刊》 6卷3期 (2005/09) Pp. 274-290

https://doi.org/10.6174/JHM2005.6(3).274

摘要

本研究主要目的在探討國軍醫院於軍人納入全民健康保險體系後，其經營效率的變化。首先利用資料包絡分析法，分析國軍醫院於軍人加入全民健保前後之經營效率，研究對象為十二家國軍醫院，並選擇性質相近之榮民醫院作比較，以瞭解其經營效率的差異。本研究再以迴歸分析探討影響國軍醫院經營效率的相關因素。
研究結果顯示，國軍醫院之經營效率，軍人納入健保後之效率較納入健保前為高。在整體效率及技術效率方面，榮民醫院均較國軍醫院顯著為高；而規模效率方面，國軍醫院則顯著高於榮民醫院。迴歸分析結果顯示，「床位利用率」、「科別數」、「市場競爭程度」、「教學醫院」及「年度別」均影響醫院之經營效率。
本研究結果除可幫助國軍各醫院瞭解其本身經營效率及改進方向外，更可作為國軍各醫院效率提昇及醫療資源配置之參考。

關鍵字

全民健康保險體系 ； 資料包絡分析法 ； 技術效率 ； 規模效率 ； 整體效率

並列摘要

This study aims to explore the change of operation efficiency of military hospitals, after military personnel in the National Health Insurance System (NHIS). In order to analyze the relative operation efficiency of military hospitals, the Data Envelopment Analysis (DEA) method is employed in this study and Veterans Affairs hospitals, with similar characteristics, are served as compared sample. A regression analysis method is then used to capture key factors affecting the operation efficiency of military hospitals.
Our results are shown as follows. First, operation efficiency of military hospitals has improved after military personnel are covered in the NHIS. Second, Veterans Affairs hospitals have higher performance than military hospitals in terms of aggregate and technical efficiency, while military hospitals are better than Veterans Affairs hospitals in scale efficiency terms. Finally, factors significantly associated with the operation efficiency of military hospitals are identified as follows: Occupation Rate of Beds, Number of Section, Rank of Hospital, Competitiveness, Fiscal year.
Taken together, our study not only helps military hospitals identify their operation efficiency but also provides a mechanism for hospitals to improve their resource allocation policy.

並列關鍵字

National Health Insurance System NHIS ； Data Envelopment Analysis ； Technical Efficiency ； Scale Efficiency ； Aggregate Efficiency

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