醫院績效衡量之研究-以高雄某區域醫院為例

The Study of Performance Measurement of Hospital: Case study at a regional hospital in Kaohsiung City

凌慧婷(Hui-Ting Ling)

指導教授 ： 蘇錦俊

義守大學/管理學院/管理碩博士班/碩士(2016年)

摘要

由於許多醫院管理者逐漸運用企業化的整體營運理念來經營醫院，以期降低醫院的營運成本，達到最佳的經營績效。一般而言，提升醫院經營績效的首要工作之一，就是透過目前現有的營運狀況進行效率衡量與評估，透過效率衡量與評估可以瞭解醫療資源的耗用情形以及自身的優勢與缺點所在，並體認外在環境所存在的機會與威脅，進而對各項醫療資源做更有效的分配與利用。本研究擬分別從財務及非財務兩方面來評估醫院的經營績效，並以多層面的觀點建立一合適的評估模式，企能將理論與實務相結合，增加績效評估的效用，以全面性的瞭解醫療產業經營績效之全貌。
本研究將各種指標加以歸納，主要可分為醫院品質績效指標、醫院經營績效指標、與醫院財務績效指標三大部份，並以這三種量化指標來衡量醫療機構之經營績效。建立經營績效量化之理論模式之後，本研究對醫院品質績效、醫院經營績效與醫院財務績效這三大部份進行相關性研究。為了探討個案醫院其品質績效、經營績效、與財務績效三者之間的關係，本研究先以杜邦方程式分析法分析個案醫院與同儕醫院的財務績效比較，最後並利用Pearson相關分析來探討上述各變數之間的相關性，然後再以多元迴歸分析詳細探討各變數與財務績效間的相關性。經由Pearson相關分析，本研究發現個案醫院其醫療品質績效、經營績效、及財務績效間都具有顯著相關性。品質構面變數與經營構面變數、財務構面變數皆呈現顯著負相關。經營構面變數與財務構面變數皆呈現顯著正相關，由此可知個案醫院之住院人數與門診人次增加，醫療收入亦會增加，但也會導致醫療照護費用增加。
根據實証分析的結果，個案醫院在改善醫院品質績效、醫院經營績效、及醫院財務績效與提高醫院經營能力之後，醫療收入與業務成本都有上升的趨勢。對於許多醫療機構目前在經營管理上所面臨的困境，本研究以科學的方法及數量化的模式，提供醫療機構在經營管理方面一個新的思考方向。在經營績效的控制與管理方面，建立一套數量化的經營績效理論模式，作為醫療機構長期監控與管理的基礎；在資源分配及運用方面，籍由醫院服務品質、醫院經營績效、及醫院財務績效三種經營績效間與各變項間相關性的探討，可讓醫療機構找出重點管理的主要目標，使管理者在策略上及決策上能有更科學、更具體的根據，最後達成改善其經營績效的目標。

關鍵字

經營績效 ； 醫院經營績效 ； 杜邦方程式

並列摘要

In order to reduce operating costs and achieve the optimum business performance, many hospital administrators have begun to apply the idea of overall operation--an enterprise concept. In general, one of the primary tasks to improve the business performance of a hospital is to make efficiency measurement and assessment based on the present operating conditions. By doing so, a hospital can distribute and utilize medical resources more effectively, by recognizing its strengths and weaknesses as well as the consumption of medical resources, in addition to the opportunities and threats in the external environment. This research assesses hospital business performance from the perspectives of financial and non-financial evaluations and establishes a multilevel evaluation model combining theory and practice to enhance the effectiveness of performance evaluation, so as to view the panorama of the business performance of the medical industry.
This research sums up various indicators, mainly including three quantitative indexes (i.e. quality performance index, business performance index and financial performance index) to assess the business performance of the medical industry. With such quantitative theoretical model, relevant researches are conducted to analyze the quality performance, business performance and financial performance of the target hospital. To explore the relationships between quality performance, business performance and financial performance of the hospital, this research first compares the financial performances in the target hospital and other hospitals at the same level by the DuPont Formula, then explores the correlation of those variables by Pearson correlation analysis, and finally discusses the correlation of variables and financial performances. From the Pearson correlation analysis, this research finds that the hospital shows significant correlations among medical quality performance, business performance and financial performance. Specifically, quality dimension variable has significant negative correlations with both business dimension variable and financial dimension variable. In addition, business dimension variable has a significant positive correlation with financial dimension variable. It can be seen that the medical income increase with the in-patient number and outpatient amount of the target hospital, but also leads to the increase of health care costs.
According to the results of empirical analysis, the target hospital presents an upward tendency in medical income f and operation cost after improving its quality performance, business performance, financial performance and operation capacity. For the common difficulties in operation and management faced by many medical institutions, this research offers a new way of thinking with a scientific method and quantitative model. For the control and management of business performance, medical institutions should establish a quantitative theoretical model of business performance as the foundation of long-term control and management. In terms of resource allocation and utilization, according to the discussion about the relationships between three operational performances (i.e. quality of service, business performance and financial performance) and those between various variables, medical institutions should recognize the major objectives of key management, enabling the administrators to have more scientific and concrete evidences in strategy and decision-making and finally improving its business performance.

並列關鍵字

operational performance ； hospital performance ； du pont identify

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