台灣醫療院所營運與經營績效之比較研究

THE COMPARISON ANALYSIS OF FINANCIAL PERFORMANCE OF HOSPITAL IN TAIWAN

黃美珍(MEI-JANE，HWANG)

指導教授 ： 古永嘉

國立臺北大學/商學院/企業管理學系/碩士(2008年)

摘要

近年來台灣經濟生活水準提高，醫療院所如雨後春筍陸續成立，醫療資源逐漸普及，全民健康保險實施後，台灣醫療產業競爭更日漸白熱化，醫療院所在面對有限的醫療資源情況下，以及台灣人口逐漸趨向高齡化等因素的影響，各醫療院所如何追求卓越經營之道，來強化競爭力以達到永續經營目的。
本研究將以財務五力分析的觀點來探討台灣醫療院所經營績效評估決定因素，除了產業特性與市場競爭及醫院營運管理的影響之外，健康保險制度及國家總體醫療政策，都是醫療院所經營績效的重要決定因子。利用財務比率來衡量醫療院所的績效及財務狀況是最直接的衡量方法，幫助組織了解本身的經營管理能力，如何藉由經營績效的衡量來達成降低成本，提高效率之目標以因應醫療環境不斷的變遷下所面臨的競爭問題。本研究藉由財務報表分析及統計方法，將國內醫療院所之經營績效作連續3年的評估，以了解醫院經營效率的成效與困境。
本研究以民國93年至95年40家之醫學中心、區域醫院及地區醫院財務績效作評比。蒐集醫療院所之基本資料及對35個變數做基本量之分析。藉由集群分析及區別分析，分析其分群結果並對其預測能力做準確度測試。最後建構出醫療院所財務績效評估模式，並對醫院近三年之績效作分析。研究結果顯示，以命中率計算，本研究的準確度為94.16%，區別醫院財務績效差異的變數依序為安全力(F2)、收益力(F1) 、生產力(F5)、活動力(F3)、成長力(F4)。
本研究理論的實證分析，得到以下的結論：1.財務五力有效的評估醫療院所經營績效，並由集群分析及區別分析得到四個集群。2.財務五力依重要性指標排序為：安全力、收益力、生產力、活動力、成長力；集群績效排序為：群體二、群體四、群體三、群體一3.各醫療院所績效最佳排序為：台安、林口長庚、振興、門諾、高雄小港醫院；各醫療院所績效最差排序為：蘭陽仁愛、康寧、義大、恆春基督、中山附醫。
本研究可作為醫療院所財務五力績效評估模型的建立及各醫療院所經營績效評斷基礎，而研究之財務資料的取得除了行政院衛生署醫事處公佈之民國93-95年財務報表資訊外，很難即時找到完整的財務資訊資料，如果往後幾年能有更多公開的財務資料平台，將更能呈現醫療院所經營績效變化的趨勢，有助於管理者發展核心專長，健全經營理念與策略方向，讓醫療院所永續經營，達到善盡社會醫療責任的使命。

關鍵字

醫療院所 ； 績效評估 ； 財務五力分析

並列摘要

The standard of living in Taiwan is improved in recent year. Medical institutions are booming and medical resource is universal accordingly. However, after implementing National Health Insurance, the competition in medical industry is more intensive. As a result, every medical institution finds the way to strengthen its own competitiveness and get sustainable growth under the pressure of limited medical resource and aging population in Taiwan.
Besides the effect of industry competition and hospital management, health insurance system and national medical policy are also the important factors to influence the performance of medical institutions. Use financial ratio to evaluate the performance of medical institutions is the most direct way and it also help organizations to understand their capability, cut down cost and increase efficiency under the competition of changing environment.
The sample of the study consisted of forty hospitals including Academic Medical Centers, Local Community Hospitals and Metropolitan Hospitals. The research period is from 2004 to 2006 and thirty-five financial ratios are collected. Use cluster analysis and discrimination analysis to cluster forty hospitals with similar characteristics and test the hit ratio of clusters. Finally, construct financial performance model for medical institutions and give sound analysis of performance within three years. The result of this study shows that the hit ratio is ninety-four percent.
The conclusions of this study are as follows:
1. Five evaluative criteria can analyze financial performance of hospitals effectively and use cluster analysis and discrimination analysis to get four clusters according to their characteristics.
2. Five evaluative criteria are sorted by importance as follows, safety, profitability, productivity, activities and growth. Four clusters are ranked by performance as follows, cluster two, cluster four, cluster three and last one is cluster one.
The top five best performance hospitals are ranked as follows, Taiwan Adventist Hospital, Chung-Guang Memorial Hospital, Chen Hsin Hospital, Mennonite Christian Hospital and Kaohsiung Municipal Hsiao-Kung Hospital. While the top five worst performance hospitals are ranked as follows, Len Yang Jen-Ai Hospital, Kung-Ning General Hospital, E-Da Hospital, Heng Chun Christian Hospital and Chuna Shan Medical University Hospital.

This study could provide the basis of setting five evaluative criteria for hospitals and evaluating the performance of hospitals. However, it is hard to collect complete financial report of hospitals in Taiwan except simple financial data being collected from Bureau of Medical Affairs, Department of Health, Executive Yuan. If there are more financial information available on public database, people can get the whole picture of performance in hospitals more easily. It will even help medical institutions develop core competence, strength operational strategy, make sustainable growth and take the national health responsibility.

並列關鍵字

hospital ； financial performance ； five evaluative criteria

參考文獻

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