醫院關鍵績效指標建立之研究－以南部某區域醫院為例

由於健保總額支付制度實施，造成各地區醫院每點金額被嚴重稀釋，歇業新聞頻傳。醫院如何藉由平衡計分卡來提升競爭力，為個案醫院正導入平衡計分卡的重要課題，故藉由本研究所訂定之策略性議題、策略目標，與關鍵績效指標，期能給予協助參考。本研究在產業分析方面，使用次級資料分析法，了解整個醫療產業環境生態，以醫療機構為目標對象，對醫療產業進行分析，進而探討醫療策略制定規劃之方向。次級資料來源為政府機構，如：經濟部、衛生署，與健保局；學術研究成果，如：博、碩士論文以及專業科目書籍。在個案研究方面，先使用專家訪談，深入了解個案醫院訂定的使命、願景、宗旨，以及目標。接下來，使用德爾菲法，建立適合個案醫院之策略性議題及策略目標，以繪製策略地圖。藉由平衡計分卡之策略地圖，探討分析各構面之策略目標與其之間的因果關係。最後，再使用德爾菲法，並根據策略地圖各構面之策略目標及其因果關係，訂定關鍵績效指標。個案醫院正在推行平衡計分卡，屬於剛開始起步的階段，因此本研究為個案醫院推行平衡計分卡的事先模擬預測。其研究成果發現大多數的平均值與眾數皆呈現正向上升的趨勢，由此顯示出專家對於個案醫院在未來持續推行平衡計分卡中的策略性議題形成、策略目標訂定，和關鍵績效指標訂定階段，其想法上皆有所共識，也提升本研究成果對個案醫院在推行上的參考價值。

關鍵字

關鍵績效指標；平衡計分卡；策略地圖；德爾菲法；產業分析

並列摘要

Due to the implementation of global budget payment systems of national health insurance, the budget of each regional hospital was diluted tremendously, at the same time, news of hospitals facing shut-down issue kept pouring in. Since the main focus for hospitals was to enhance competitive competence through balanced scorecard, it was expected that the strategic topics, strategic objectives and key performance indicators would be useful for the hospitals in this research. In view of industrial analysis, this research adopted secondary analysis to realize the overall ecology of healthcare industry. This research took healthcare institutions as subjects to conduct analysis upon healthcare industry, and further discussed the direction of establishment and planning of healthcare strategies. The sources of secondary research were governmental entities, such like: Ministry of Economic Affairs, Department of Health and Bureau of National Health Insurance, while the sources of academic results were professional writings, master and PhD essays. As for case study, this research firstly applied expert interviews to deeply realize the mission, vision and purpose of case hospital, and then adopted the Delphi method to construct appropriate strategic topics and objectives, and plotted the strategy map. With the strategy map in balanced scorecard, this research discussed and analyzed the strategic objectives from each dimension and the casual relationships among them. At last, the Delphi method was adopted again to define the key performance indicators through the dimensions from strategy map and the casual relationships. It was still the initial stage of promoting balanced scorecard for the case hospital. Therefore, this research prepared a simulated prediction of implementing balanced scorecard in advance for the case hospital. The results showed most of the means and modes of research variables were elevated in a positive way, and thus proved the consensus of experts upon case hospital promoting the formation of strategic topics, establishment of strategic objectives and key performance indicators from balanced scorecard. This research result further elevated the value of reference for case hospital in promoting the balanced scorecard scheme.