醫院引進及擴張新醫療科技之影響因素與結果

Antecedents and Consequences of the Adoption and Expansion of New Medical Technology in Hospitals

羅萱(Hsuan Lo)

《台灣公共衛生雜誌》 24卷5期 (2005/10) Pp. 385-393

https://doi.org/10.6288/TJPH2005-24-05-02

摘要

目標：本研究目的在瞭解醫院引進與擴張多種新醫療科技的決定因素，及擴張醫療科技設備後對組織營運的影響。方法：利用次級資料進行縱貫性研究，研究群體為民國83-91年台灣地區所有層級的綜合型醫院。以負二項迴歸之隨機效果模式，分析組織與環境因素對新引進醫療科技的影響；以一般線性迴歸之隨機效果模式，分析新引進醫療科技對次年醫療科技利用量的影響。結果：描述性分析結果發現，民國83年至91年間擁有一種或擴張多種高科技醫療儀器的醫院比率有增加的情況。迴歸模式分析發現，醫院權屬別、科別數、規模、及醫療儀器利用量等因素對新引進醫療儀器機率為正向顯著影響，而醫療儀器種類數為負向顯著影響；然而，新引進醫療儀器種類數對次年醫療科技利用量則為負向顯著影響。結論：第一組織特徵因素是影響醫院引進及擴張新醫療科技種類的重要因素，尤其生存壓力較大的組織（如私立醫院）、異質醫療專業需求高的及資源與能力強的組織（如規模大、科別多及利用量高的醫院），引進及擴張新醫療科技種類機率越高；第二、組織若過度的擴張多種醫療科技，將導致較低的醫療科技利用量。

關鍵字

醫療科技 ； 引進 ； 擴張 ； 效率

並列摘要

Objectives: The purposes of this study are to examine the effects of organizational and environmental factors on the adoption and expansion of new medical technology in hospitals and to examine the effects the adoption and expansion of new medical technology on hospitals’ performance. Methods: We analyzed a panel of hospitals in Taiwan between 1994 and 2002 and used the secondary data from the governmental archive. Negative binomial regression with the random effects model is used to examine the effects of organizational and environmental factors on the adoption or expansion of new medical technology. In addition, the random effects general regression model is used to examine the effects of the adoption and expansion of new medical technology on organizational efficiency. Results: Regression models showed that private hospitals, sizes, the number of specialties, and medical technology utilizations had positive impacts on the adoption and expansion of new medical technology, and the numbers of medical technology categories had a negative effect. However, increases in the adoption and expansion of new medical technology had a negative impact on organizational efficiency under controlling the categories of medical technology. Conclusions: Our study suggests that organizational factors are key determinants of the adoption and expansion of new medical technology, and that the greater the survival pressure (e.g., private hospitals), diversity of medical demand and the more capabilities and experience of the hospital (e.g., large size, more numbers of specialties, and high utility) the greater the likelihood the hospital will adopt and expand new medical technology. Further, we suggest that over-adoption and over-expansion of new medical technologies will reduce medical technology utilization unless the categories of medical technologies were also considered.

並列關鍵字

medical technology ； adoption ； expansion ； efficiency

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