醫院實施聯合採購現況分析

Analysis of Current Status for Hospital Group Purchasing

羅淑玲(Shu-Lin Lo)

指導教授 ： 郭乃文博士

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2004年)

摘要

全民健康保險在84年3月實施、總額預算陸續上路、並在91年4月份全民健保藥價給付調降後，藥價基準實施使得藥價透明化，醫藥分業使病患在醫院取藥的機率降低，醫院的利潤也可能因此減少；醫院大型化及連鎖式的陸續設立，許多中小型的醫院已陷入艱苦的經營地步。 本研究主要目的為了解醫院實施聯合採購現況、探討醫院加入聯合採購的整體滿意度、調查聯合採購供貨品質的穩定度、瞭解醫院施行聯合採購的採購成本下降情形、無論現在是否有參與聯合採購，在未來(繼續)參與聯合採購的意願。本研究採橫斷性研究，本研究之對象為行政院衛生署八十九至九十二年度醫院評鑑暨教學醫院評鑑合格名單，等級為地區醫院(含)以上之醫院為主共515家。問卷調查的主要對象為醫院採購主管採用郵寄問卷調查；各層級的內外科醫師計8人採專家訪談方式進行。回收問卷共計211份，其中因有3份回答不完整而捨棄，有效問卷為208份，回收率為40.3%。其中參與聯合採購醫院為109家(比率為52.4%)。 研究結果顯示：(一)聯合採購的品項及金額的分配情形並未因醫院經營型態不同而有顯著差異。(二)不同經營型態醫院對參與聯合採購電子化的程度有顯著差異。(三)不同經營型態醫院對聯合採購的適當醫材品質有顯著差異。(四)不同經營型態醫院對聯合採購績效(成本下降)未有顯著差異。(五)有90.4%醫院會在未來(繼續)參與聯合採購。

關鍵字

醫療產業 ； 經營型態 ； 聯合採購

並列摘要

After implementation of the National Health Insurance (NHI) in Taiwan in 1995, the medical environment was dramatically changed. Furthermore, the NHI of Taiwan adopted a global budget payment system for hospital reimbursement in 2001, maknig the medical environment more complicate. Additionally, the expansion of medical centers and hospital systems also makes many middle to small size hospitals more difficult to survive. Therefore, hospital administrators developed many strategies, such as group purchasing, to cope with this changing environment. The purpose of this study was to understand the current status for hospital group purchasing in Taiwan and to evaluate degree of satisfaction and stability of product quality in group purchasing. In quantative study, a questionnaire was sent to the directors of purchase department of 515 hospitals, which were accredited as the level of district hospitals or above, to collect data related to group purchasing. In the part of qualitative study, 8 physicians were interviewed. Finally, 208 valid questionnaire were obtained. The return rate was 40.3%, among them, 109 hospitals (52.4%) had participated group purchasing. The results showed: 1. There were no correlation between number of items, dollar amount of group purchasing and hospital alliance strategies. 2. There were significant correlation between hospital alliance strategies and the degree of computerization of group purchasing system. 3. There were significant correlation between hospital alliance strategies and quality of products from group purchasing. 4. There was no significant correlation between hospital alliance strategies and cost reduction from group purchasing. 5. There were 90.4% hospitals, which planed to join or continue participating group purchasing in the future.

並列關鍵字

Healthcare industry ； Management style ； Group purchasing

參考文獻

林佩珍(2001)。醫院院際合作型態暨合作成效評估。未出版碩士論文。長庚 大學醫務管理研究所。 彭朱如、王維元、張錦文(1998)。醫院對外合作策略與績效評估。 醫院雜誌，31(2)，32-43。 莊逸洲(1995)。前瞻性支付制度下的成本管理及品質改善。長庚紀念 醫院二十週年國際研討會講義。 莊馥蓮、王淑玲、劉秋玉(2002)。手術室衛材管控改善方案。榮總護理，19(1)， 53-62

李珞琳(2001)。醫療機構策略聯盟型態及其績效評估。未出版碩士論文。台 北醫學院醫學研究所。

嚴建藏(1987)。省市立醫院連鎖經營之研究。未出版碩士論文。中國醫藥學 院醫務管理研究所。 劉英華、蕭惠卿(1998)。以企業管理方法強化醫院管理。黃埔學報35輯。 241-250。 蘇勳璧、彭朱如、鄧振華(2001)。不同等級醫院其資源優勢、策略優勢 與績效之關係。醫務管理期刊，2(1)，93-108。 蘇義雄、錢慶文、林文德(2001)。醫院產業對藥品供應商物流服務需求要素 及相對要度之研究。中山管理評論，9(4)，513-536

Larson, Paul D. (1994). Buyer-Supplier Co-Operation, product quality and total costs, International Journal of Physical Distribution & Logistics Management 24(6), 4-10.

Novack, Robert A. (1991). Industrial Pruchasing: A managerial model of coporate quality planning, management and control, International Journal of Physical Distribution & Logistics Management 21(1), 3-12.