醫院推行全面品質管理對經營績效影響之研究

The Relationship between Operation Performance and Implementation of TQM in Hospitals

陳福基(Fu-Chi Chen)

指導教授 ： 詹前隆

元智大學/管理學院/管理研究所/碩士(1998年)

摘要

自從84年3月全民健保開辦之後，國民就醫權益獲得進一步的保障，但也衍生醫療費用遽增的問題，健保局為解決財務赤字壓力，陸續推出論病例計酬案件，醫療機構為因應此一經營壓力，紛紛開始推行全面品質管理，因此全面品質管理成效及評估方法，便成為一重要議題。
本研究主要運用1998年公佈之美國國家品質獎醫療產業評估準則，調查中央健保局台北分局下轄地區級以上醫院TQM實施現況，本研究共發出165份問卷，回收42份，回收率為25%，結果顯示國內醫院推行TQM超過4年醫院僅佔18%，品管活動中以臨床路徑及品管圈最常為醫療機構採用，從台北分局提供之次級資料中顯示，TQM醫院及非TQM醫院在經營績效差異分析方面，發現股及腹股溝疝氣修補術、前列腺切除術於醫療成本耗用有顯著差異，但住院日部份則未發現有顯著差異，在推行TQM時間部份則發現，推行時間愈長，兩者間差異會更顯著。

關鍵字

全面品質管理 ； 美國國家品質獎 ； 醫院經營績效

並列摘要

Since insurance of civic was executed in March 1995, the civil right of medical treatment obtains further fair, but it also results that the expense of medical treatment highly increases. To solve the finical deficit, Bureau of National Insurance sequentially implement the policy of casepayment for dealing with the operational pressure , medical institutions begin to execute TQM. Therefore, how to evaluate the effect of TQM becomes an important issue.
The study is according to medical industry evaluation criterions published by Malcolm Baldrige National Quality Award in 1998 and investigates the situation of TQM in the hospitals, which belong to Bureau of National Insurance Taipei Branch .The study sends 165 questionnaires and receives 42 questionnaires. The response rate is 25%. The conclusion shows Taiwan hospitals, which implement TQM over 4 years, are only at 18%. The clinical path and quality control circle are often accepted in the activities of TQM by medical institutions.From the secondary data provided by Bureau of National Insurance Taipei Branch .The difference analysis of hospital operational performance between TQM and
Non-TQM hospitals shows that medical cost in two disease makes significant differences, but no significant differences in length of stay. Besides, we find that the longer time of implementing TQM the more differences will be made between both hospitals.

並列關鍵字

TQM ； Malcolm Baldrige National Quality Award ； Hospital Operational Performance

參考文獻

韓揆(1994)，醫療品質管理及門診服務品質定性指標。中華衛誌，13(1)p.35-52。

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