台灣醫學中心及區域醫院經營績效評估研究

Abstract

本研究探討二代健保制度實施後，2013年度健保全台特約20家醫學中心及87家區域醫院之經營效率評估，並討論在現行總額給付制度及醫護人力資源短缺下，相對無效率醫院如何在低投入情況下調整為最有效率的營運模式。研究資料來源為行政院衛生福利部機構公開資訊查詢專區，透過多投入及多產出變項，以資料包絡分析法(DEA)及共同邊界資料包絡分析法(Metafrontier DEA)探討醫學中心、區域醫院兩群體組間及組內相對經營效率，並以CCR及BCC模式進行分析。

研究結果顯示兩群體相較而言，醫學中心技術相對領先，區域醫院效率相對較高，推估可能原因為兩群體業務範圍與醫療業務難度不同，但本研究之產出變項主要集中於醫療業務，未擴及其他指標項所導致之差異。研究建議主管機關及區域醫院管理階層均應擬定長期計畫，著重技術水準之提升，同時主管機關就全台整體資源分配或醫院管理階層對於院內資源分配，均應著重於醫療資源合理配置，以提升整體經營效率。惟需特別留意醫療院所終究屬於非營利事業，且醫療行為關乎性命，故透過各變項探究經營效率與財務指標時，萬萬不可犧牲了醫療品質。

The Study discusses operating performance efficiency of 20 medical centers and 87 regional hospitals which are special hospitals of Taiwan National Health Insurance (NHI) since 2nd Generation NHI has been conducted in 2013 and further proposes possible suggestion for those with inefficiency under current circumstances of Global Budget System and limited medical professionals.

This study applies DEA and Metafrontier DEA method which can concurrently reflect multiple input variables and multiple output variables to evaluate the operating performance between and within two groups, medical centers and regional hospitals, and analyzes by CCR and BCC models. Study data is retrieved from Facility Open Data, Ministry of Health and Welfare.

The result of study reveals medical centers have more advanced technique levels and regional hospitals have higher efficiency compared with another group. However, it may result from different operating practices and disease complexity between two groups due to output variables of this study are mainly focused on medical practice. Both government and regional hospitals’ administration have to set up long-term plan to elevate technique levels, and they should emphasize on optimal allocation of medical resources in order to strengthen overall operating performance efficiency. Last but not least, healthcare facilities are non-profit organizations and all of its practices are closely-related to human life, so medical quality should be put on the first priority no matter what kind of variable or financial index is selected into future study.