醫療院所醫療儀器採購決策支援系統之建構與評估

The Construction and Evaluation of a Decision Support System for Medical Instruments Purchasing in Hospitals

蔡佳吟(Chia-Yin Tsai)

指導教授 ： 陳金淵

長榮大學/健康科學學院/醫務管理學研究所/碩士(2006年)

https://doi.org/10.6833/CJCU.2006.00066

摘要

近年來，國內醫療院所為了因應保險給付制度之變革所造成之營運收入困境，無不積極思考如何節省各項醫療成本。其中，醫療儀器購置成本約佔醫療院所費用支出總額之20~30%，僅次於人事費用成本。然而，在市場競爭日益嚴重之情況下，醫療院所仍不惜重金引進各項新穎之醫療儀器設備，以提高市場競爭力。因此，如何審慎評估貴重儀器投資決策乃成為醫療院所之一大課題。本研究以管理科學為基礎，建立醫療儀器採購評選模式，期冀透過完整、客觀的決策過程，協助醫療院所提昇相關決策品質。
藉由文獻探討，本研究研擬出「醫療儀器採購之關鍵評估準則」問卷，並由十五位專家學者進行效度檢測。彙整專家意見後，利用分析層級程序法（Analytic Hierarchy Process，AHP）之理論概念，並使用Visual Basic 6.0、Microsoft Office Access 2003與Crystal Reports XI作為開發工具，建置完成一套醫療儀器採購決策支援系統。
本研究為瞭解系統成效及使用者滿意程度，針對18家地區級以上醫院之參與採購者進行郵寄問卷，另外7家進行實地解說及問卷發放，請受訪對象於操作本系統後填寫成效評估問卷；總計回收30份實際使用者之調查問卷。
將近三分之二的受訪者對系統品質、系統效益與使用者滿意度等三個面向中的十七項（全部十九個項目）預期系統價值表示認同；將近一半的受訪者在減少採購作業成本支出、AHP資訊內容之介紹等兩個評估項目表示滿意。整體而言，受訪者普遍肯定本系統之價值，認為本系統可以協助醫療院所提升組織內採購作業之溝通效果、節省個人或機構之決策時間，並增進整體之決策品質與效益。

關鍵字

醫療儀器 ； 採購模式 ； 分析層級程序法 ； 決策支援系統 ； 系統評估

並列摘要

Recently, domestic hospitals have been actively considering how to contain medical costs in response to the decreased reimbursement fees caused by the ever-changing health insurance system reforms. While the medical instrument costs comprise approximately 20-30 percent of health service expenditures, only second to the cost of personnel, hospitals still keep spending a lot of capital on new medical instruments to strengthen marketing competition capability. Therefore, it deserves more attentions evaluating the investment decision on expensive instruments thoroughly beforehand. This study aimed to build a medical instrument purchasing model based on appropriate management science techniques in the first. Then, using the purchasing model as foundation, this study developed a decision support system to help hospitals enhance their quality of purchasing decisions.
A “Survey of Key Evaluation Criteria for Medical Instruments Purchasing Decisions” questionnaire was developed through literature review and its validity was tested by fifteen experts from the academia or the industry. Then, based on the Analytic Hierarchy Process (AHP) theory, a decision support system for medical instruments purchasing was constructed with the aid of Visual Basic 6.0, Microsoft Office Access 2003, and Crystal Reports XI as system developing tools.
To examine the system performance, an evaluation questionnaire was mailed to people involved in medical instruments purchasing decision activities at 18 community-level or above hospitals along with another eight hospitals through in-person visits to solicit their evaluations and opinions on the system. In total, 30 valid questionnaires were collected.
Approximately, two thirds of respondents gave positive evaluations on 17 items (out of 19) in the areas of system quality, system effectiveness and users' satisfaction. About half of the respondents were satisfied with purchasing costs reduction and the introduction of AHP content. Overall, respondents recognized the benefits of using this system in the belief that the system could help hospitals improve communication effectiveness in the process of purchasing, save an individual's or the organization's decision time and, more important, enhance decision quality and effectiveness on the whole.

並列關鍵字

Medical Instrument ； Purchasing Model ； Analytic Hierarchy Process ； Decision Support System ； System Evaluation

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