我國各類公立醫院經營效率之實證研究

A Study on Operating Efficiency of Public Hospital－The Case of Taiwan

楊志春(Chin-Chun Yang)

指導教授 ： 林江亮

中原大學/商學院/會計研究所/碩士(2006年)

https://doi.org/10.6840/cycu200600540

摘要

我國公立醫院在醫療體系中負有社會政策責任，然面對政府財政日趨困難預算經費緊縮，以及龐大醫療成本的問題，醫院應該如何有效地配置內部資源、控制成本，在管理上的確是一個急需解決的課題。
本研究係利用資料包絡分析法(Data Envelopment Analysis, DEA)分析我國公立醫院之經營效率，以「行政院衛生署90-93年度醫院評鑑暨教學醫院評鑑合格名單」中，評為「區域醫院」以上者為研究對象，分別以CCR及BCC模式評估其整體效率及純技術效率，並經由差額變數分析，具體探討各醫院無法達到相對效率之主要原因，提供相對無效率DMU投入及產出項改進方向與幅度。
研究結果顯示，在整體效率方面：教育部在整體經營效率上與其他體系醫院相較有顯著性差異，即教育部優於衛生署等同於國防部優於退輔會。在純技術效率方面：僅教育部與衛生署有顯著差異，顯示教育部在投入資源運用上，相較於衛生署更有效率，餘各體系醫院間沒有差異。
由差額變數分析結果可知，退輔會體系醫院無論在CCR模式及BCC模式方面，在現有規模之下，須減少之平均投入量均較其他體系醫院為多，惟就投入項「總樓板面積」之BCC模式方面，國防部體系醫院須減少之平均投入量均較其他體系醫院為多，方能達到最適效率。
本研究結果，除可提供各體系公立醫院瞭解其經營效率及改善方向外，並可列為公立醫院擬定醫療政策之參考。

關鍵字

資料包絡分析法 ； 技術效率 ； 純技術效率 ； 整體效率 ； 規模效率

並列摘要

The public hospitals in our medical care system in Taiwan take the responsibility of social policy. It is really a critical problem for us to solve in face of the deficient budget, considerable medical cost and how to distribute the inner resource in hospital and how to control the cost.

Our research uses the Data Envelopment Analysis, DEA, to analyze the efficiency of management of public hospitals in Taiwan. The subjects of our research are the Area Hospitals, which are on the certified list according to the assessment of Health Agency from annual 2001 to 2004. We use individually the model of CCR and BCC to assess the Overall Efficiency and Technical Efficiency. Also, we use the Slack Variable Analysis to confer the main reasons why the hospitals can’t reach the relative efficiency and offer the way to improve about the inefficient input and output of DMU.

The result indicates that Education Bureau is significant in the management of Overall Efficiency than other kinds of hospitals. That is, Education Bureau is superior to Health Agency and National Defense Bureau is superior to Veteran Consultation Commission. Education Bureau and Health Agency have significance in Pure Technical Efficiency. It indicates that the utility of the input resource in Education Bureau is better than in Health Agency. And the others have no significance.

In accordance with the result of Slack Variable Analysis, no matter in the respect of CCR and Bcc model, the hospitals which are under Veteran Consultation Commission have to reduce the average input in the present scale. In the item of input of Overall Floor Square Measure, in order to reach the proper efficiency, the hospitals which are under National Defense Bureau need to reduce the average amount of input.

The result of the research can offer the way to improve and understand the efficiency of management in public hospitals. In addition, it can be the reference to formulate the medical care policy in public hospitals.

並列關鍵字

Pure Technical Efficiency ； Technical Efficiency ； Overall Efficiency ； Scale Efficiency ； Date Envelopment Analysis( DEA) ； Slack Variable Analysis

參考文獻

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