住院日控制及病床週轉率於醫院經營績效相關性之研究 -台南某區域醫院內科病房為例

A research of the hospital management on Length of Stay and Bed Turnover Rate -- An example of the medical ward in a region hospital in Tainan area.

李宗霖(Tsung-Lin Li)

指導教授 ： 張晴翔

長榮大學/健康科學學院/醫務管理學研究所/碩士(2007年)

摘要

全民健保實施讓全民普遍受到醫療保險的照顧，但也造成醫療服務需求快速增加。面對醫療受益者對於醫療品質越來越嚴苛的要求，而健保財務卻開始出現入不敷出的困境，醫療服務提供者所面對的不僅是越來越艱困的競爭環境，對於醫院營運成本不斷上漲的趨勢，已嚴重威脅到醫院的生存。因此，如何藉由「經營績效」的衡量來達成降低成本提高效益之目標，是現今醫療機構最重視的議題之一。

而醫院當中住院日的控制與病床週轉率的變動直接影響醫院的經營績效，因此有效、並有彈性的對於住院日做控制與病床週轉率的監控，不只可降少住院資源的浪費，同時可提高醫院對病人的住院照護水準。而醫院之經營績效，國內外專家學者有許多不同的看法，特別在衡量的方法上，不同的學者所採用的衡量指標亦不盡相同。經過文獻探討後，而就衡量指標而言，本研究以醫療服務品質績效、生產力績效、與財務績效這三大構面來衡量醫療機構的經營績效。

　　本研究有以下幾點研究結果與發現：
一、對於住院日的控制與病床週轉率的監控，提供一套模式化的衡量
模式。
二、根據實證分析的結果，個案醫院在改善醫療服務品質與提高生產
力之後，醫療收入有上升的趨勢。
三、病床週轉率與佔床率的高低存在著相互影響的關係，並進一步造
成財務不同的收入，故住院日的控制上將有相當程度地顯著影
響。

關鍵字

經營績效 ； 住院日 ； 病床週轉率

並列摘要

The implementation of the National Health Insurance (NHI) has offered extensive medical care to the resident in Taiwan, while it also results in great demand for healthcare service. With the beneficiary requests a larger service scope with better quality, the Bureau of National Health Insurance (BNHI) is confronted by deficits. The medical service provider is facing tougher and tougher competition. The sharp increase of the expenditures in the hospital operations has caused serious threats to the hospital systems. Therefore, how to reach the goal of decreasing production cost and increasing service value plus performance through management is the top critical issue nowadays of the modern medical institutions.

Since variations of the control over the length of stay and bed turnover have obvious influences on management performances in the hospitals, a flexible and proper surveillance on the length of stay and bed turnover rate not only keeps away from the waste of hospitalization but also raises the level of nursing for patients. There are kinds of perspectives for hospital management concept worldwide especially on measurement methods. Different measurement indicator is to be adapted by different schools of research fellowship. After doing variety of research, this memoir is to valuate the hospital management based on medication and treatment service quality, productivity performances, and financial performances.

The following is what we are finding:
A. A series of measurement formulae is to be workable for
the surveillance on the length of stay and bed turnover
rate.
B. An objective measurement, according to the analysis of
approval data, on the improvement of medication and
treatment service quality and productivity of every
hospital is to be workable for tracking of medication
and treatment service income.
C. Bed turnover rate and occupancy rate varies each other,
which also varies financially. Consequently the control
over length of stay is critical.

並列關鍵字

Management performances ； Length of stay ； Bed turnover rate

參考文獻

1.于美德(2002)。心導管檢查醫療資源耗用分析。國立陽明大學醫務

3.王昭月(1995)，從營運績效的比較探討省立醫院的經營方針，私立

4.行政院衛生署中部辦公室(2001)，本署所屬醫院VS競爭醫院醫療資

9.李紫娟(1995)，醫療儀器資本預算分析與財務績效關係之研究，中

23.劉季貞(1999)，醫療服務品質之實證研究─以大高雄地區醫院為