台灣醫療產業生產力與效率實證研究之回顧與展望

A Review of Empirical Studies on Productivity and Efficiency in Taiwan's Healthcare Industry

李文福(Wen-Fu Lee) ； 王媛慧(Yuan-Huei Wang)

《輔仁醫學期刊》 4卷4期 (2006/12) Pp. 215-230

摘要

背景和目的：近年來已開發國家醫療支出快速成長的趨勢，亦使得醫院的營運績效問題成為公眾探討的話題。為了控制醫療支出之成長，醫療照護的提供者－醫院之營運績效，實扮演著舉足輕重的角色。截至目前為止，國際及國內期刊已累積有相當的研究成果。方法：本研究從醫院的營運績效－效率（實際生產活動與生產前緣相近的程度）與生產力（生產前緣之移動）出發，分為以下三個部分作討論：1.從醫院生產理論與實證角度，說明在進行醫院產業效率與生產力的相關研究時，所需的資料特性。進而介紹效率與生產力變動理論，及其估計方法之探討。2.回顧、整理近十多年來國際及國內有關醫院效率與生產力變動的相關文獻。比較國外與國內相關文獻，說國內既有文獻不足之處，提出未來醫院營運績效之研究方向。3.針對國內未來有興趣從事醫院營運績效之研究者，本文整理並討論目前可取得之醫院產業資料庫，包括有：台灣地區公私立醫療院所現況及醫院服務量調查，全民健康保險學術研究資料庫，醫療品質指標資料庫，醫院財務資訊等；並就使用資料時應注意之處，與資料庫的改進提出建議。

關鍵字

醫療產業 ； 經營績效 ； 效率 ； 生產力

並列摘要

Background and Purpose: The rapid growth of healthcare expenditures in developed countries has made hospital performance an important subject Hospital performance is the key to maintaining the solvency of the National Health Insurance (NHI) program in Taiwan and providing proper provisions for contingencies. There has been a significant amount of related research published in academic journals Methods: This article reviews empirical studies regarding hospital efficiency (the relationship between the actual production activity and the production frontier) and productivity (the shift of the production frontier). There are 3 main parts.
1. We discuss how to choose input, output, and quality variables from the production theory of hospitals. We also review the theories of efficiency and productivity change, and their estimation methods.
2. We review research results on hospital efficiency and productivity in the past decade. Different empirical techniques and external factors are discussed. We provide several possible directions for future research on hospital performance.
3. With researchers interested in the study of hospital performance in mind, we provide a review of the available datasets in Taiwan, including. The Current Status and Utilization Survey on Public and Private Health Service Providers, The NHI Academic Research Database, The Health Care Quality Index Database, and hospital financial data.

並列關鍵字

hospital industry ； operating performance ； efficiency ； productivity