醫院績效與資訊科技彈性關係及衡量模式建立研究

The Relationship between IT Infrastructure Flexibility and Hospital Technical Efficiency and Building the Performance Evaluated Model

楊馥甄(Fu-Jeng Yang)

指導教授 ： 林榮禾

國立臺北科技大學/管理學院/商業自動化與管理研究所/碩士(2006年)

摘要

我國政府開辦全民健康保險，象徵著有限的醫療資源將重新分配並依據支付標準來申報醫療收入，造成台灣整體醫療環境面臨前所未有的競爭。因此，醫院必須降低醫療成本與提升醫療品質來提高競爭力，方能達永續經營之目的。近年來，資訊科技的進步，包括軟體應用、硬體功能提升及網際網路的應用發展，支援醫護人員的作業效率，並提高醫療行政效率，以提昇整體醫療照護與服務品質。醫院為提升經營績效必須就現有的營運狀況進行效率衡量與評估，本研究將以資料包絡法（Data Envelopment Analysis, DEA）來評估醫院的經營效率，再以Tobit迴歸法探討資訊科技基礎建設彈性對醫院營運效率之影響，瞭解何種因素對醫院經營效率的影響最為顯著，預期能做為政府機關在推動國內各級醫院經營效率與資訊化的參考依據。另外利用分類與迴歸樹（Classification and Regression Tree, CART）建立醫院經營效率判別的規則，以建構醫院經營效率衡量模型。結果顯示國內醫學中心的技術效率較區域級、地區教學醫院為高，且醫院規模及整體資源的運用與配置，皆較為良好。資訊科技之間的相容程度、資料的透通程度、管理相關的知識和專業技術的知識與醫院技術效率呈現顯著正向影響。分類樹模型，在學習樣本群部份，平均分類正確率為89.29%；在測試樣本群部份，平均分類正確率為75%，因此具有穩定的分類效果，所得到判別規則可做為醫院初步衡量經營效率之參考。

關鍵字

資料包絡法 ； 醫院績效評估 ； 資訊科技彈性

並列摘要

Taiwan started its National Health Insurance Program（NHIP）on March 1, 1995. It means limited medical resources redistributed and medical income registered by payment standard. It causes the unheard-of competition in the whole medical environment in Taiwan. Therefore, hospitals must decrease medical cost and raise medical quality to improve competitiveness and achieve the purpose of sustainable business. In recent years, the advancement of information technology including applying software, raising computer hardware function and developing internet application greatly supports the operational efficiency for doctors and nurses and raises the administrative efficiency to improve the whole medical care and service quality.
This research proposes a model to evaluate a hospital’s efficiency and discusses the effects of IT infrastructure flexibility on hospital’s efficiency. The purpose is to know what factors affect hospital’s efficiency most significantly. The research methods includes the data envelopment analysis（DEA）, Tobit regression（TR） and classification and regression tree（CART）. This research applies DEA to evaluate hospitals’ efficiencies. Then, we use CART to build the model to find the rule of evaluating a hospital’s operation efficiency. Further, we use the TR method to find the effects of IT infrastructure flexibility on hospital’s operation efficiency. This research could be a valuable reference for government to promote domestic hospital’s operation efficiency and IT update. Results indicate that medical centers significantly operate more efficiently than regional hospitals and district teaching hospitals. IT compatibility, data transparency, management knowledge and technical knowledge positively contribute to the efficiency for hospitals. The classification tree constructed in this study, the average correct classification rate is 89.29% for learning sample and the average correct classification rate is 75% for testing sample. This research could be a valuable reference for hospitals to evaluate operation efficiency.

並列關鍵字

Data Envelopment Analysis ； IT Infrastructure Flexibility ； Hospital Technical Efficiency

參考文獻

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