近來雖有許多以績效為研究主題的報告及文章陸續發表,但對績效的定義不僅仍存有不同的看法,甚至對績效的範圍亦都有極大之差異與不同。以現有對績效的瞭解及知識而言,任何嘗試以單一特定分析架構來分析績效將是無法完整詮釋績效,但若因此而放棄發展一完整的績效分析架構也是相當可惜且不利於健康制度整體效能之提升。 因此本文的主要目的在回顧並檢視各種績效理論及各國用以衡量及促進其健康制度績效的各種模式,並嘗試提出一整合性模式做為醫療衛生政策之參考。希望能夠對政府及相關組織在建立健康制度績效衡量模式時有所助益,使得不同的健康照護體系不僅得以加以比較,並進而促進其績效的提升。 本文首先說明績效的重要性,其次依序分別探討各種績效理論、績效的範疇、各國健康制度所採用的績效衡量模式,績效衡量模式訂定時可能遭遇的困難,最後提出一整合性模式。
Giving the recent reports and publications on the subject of performance, that the concept of performance can still mean many different things and that the boundaries are still hard to draw, any attempts to impose a unique analytical framework would certainly be detrimental, given the current state of knowledge. But to develop no framework at all would be just as detrimental. The purpose of this paper is to examine the approaches adopted by these health systems in several countries to measure and improve system performance and to recommend a preferred approach. The recommendations should assist organizations and governments interested in establishing common measures that enable meaningful comparisons among health systems and contribute to performance improvement. It is also anticipated that this paper will be of assistance to health systems in Taiwan in their establishment or refinement of performance measurement system.
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