台灣小型醫院新設與歇業之影響

Factors Affecting Opening and Closure of Small Hospitals in Taiwan

劉容華(Jung-Hua Liu) ； 江東亮(Tung-Liang Chiang)

《台灣公共衛生雜誌》 20卷1期 (2001/02) Pp. 27-33

https://doi.org/10.6288/TJPH2001-20-01-04

摘要

目的：本研究旨在分析1987至1997年間，100床以下小型醫院新設與歇業的分布及其決定因素。方法：本研究採用次級資料分析方法，資料來源為行政院衛生署的「臺灣地區公私立醫療院所現況調查」，以及內政部出版的「臺閩地區人口統計」。本研究利用對數複迴歸分析，探討醫院組織特性與環境因素兩類變項，與醫院新設或歇業的關係。結果：1987至1997年間，臺灣醫院自802減少為624家，雖然有193家醫院新設，但歇業醫院卻高達371家。就醫院規模而言，89.6%的新設醫院與99.7%歇業醫院，都在100床以下。對數複迴歸分析顯示：新設醫院的規模傾向小於50床，並且蓋在都市化程度中等、各類型醫院數皆少的次醫療區；但歇業醫院傾向為舊設醫院、私立、及規模50床以下，並且位於大型醫院數多，以及賀芬達指標低的次醫療區。結論：臺灣小型醫院的新設和歇業，與醫院組織特性及環境因素均有顯著相關。(台灣衛誌2001;20(1):27-33)

關鍵字

小型醫院,醫院新設,醫院歇業

並列摘要

Objective: This study aims to examine the factors associated with the establishment of new hospitals and hospital closures (all with less than 100 beds) in Taiwan from 1987 to 1997. Methods: Secondary data were used for analysis. These data were obtained from “The Annual National Hospital Survey”, conducted by the Department of Health, and the “Taiwan-Fukien Demographic Fact Book”, published yearly by the Ministry of the Interior. Multiple logistic regression was applied to explore whether hospital characteristics and environmental factors were associated with opening and closure of hospitals. Results: Between 1987 and 1997, there were 193 new hospitals and 371 hospital closures. As a result, the total number of hospitals in Taiwan decreased from 802 to 624. In terms of size, 89.6% of the new hospitals and 99.7% of the closed hospitals were with to 624. In terms of size, 89.6% of the new hospitals and 99.7% of the closed hospitals were with less than 100 beds. Our multiple regression models reveals that, compared with existing hospitals, most of the newly opened hospitals had less than 50 beds. Similarly, a majority of the hospitals that closed between 1987-1997 were privately owned with less than 50 beds. Moreover, these hospitals tended to be located in districts where medical centers and regional hospitals already exist, as well as in districts with a lower Herfindahl index. Conclusions: Both hospital characteristics and environmental factors were associated with the opening and closure of small hospitals in Taiwan.

並列關鍵字

Small Hospitals,Hospital Opening,Hospital Closure.