醫院經營績效之評估與資料包絡分析法權數設限之研究

Abstract

有別於其它計量分析工具，本文嚐試以資料包絡分析法 (DEA) 來評估非 營利性組織－醫院之經營效率，並對 DEA理論、演進及改良作一番探討， 同時印證學者們的各種權數設限方法，及創新一種從作者實證分析經驗中 所得知的權數設限方法－倍率向量絕對設限法(Assurance weight vector's flexible space of absolute bonuding,AFSAB)。非營利組織 之績效評估常為多元準則且不易量化，同時在實證上其投入產出間之函數 關係並不顯著，此時若以參數估計法來評估其效率，即產生實質上的困難 。由於 DEA方法具有良好的客觀評估特性，委實為評估非營利組織績效之 一有效方法。 DEA模式中之權數，代表該觀測點對參考變動空間之"法向 量"，也 "隱含"著各投入產出項對整體效率值之貢獻程度，由於每一生產 要素有其固有稟賦，若存在任一權數值為零之情況，將造成在經濟學上或 管理功能意義上無法解釋之情形。為改善上述現象，本研究以市立醫院經 營效率之評估為例，運用 DEA效率評估模式來說明，權數若不加以設限， 將使效率分析產生錯誤，甚至誤導管理決策，並希望後續學者在運用 DEA 模式評估組織績效時，應將權數設限之變動範圍對整體效率之影響，嚴予 納入考量。 Unlike conventional approaches for evaluating organization efficiency, a developed mathematical programming technique, Data Envelopment Analysis(DEA), is able to handle multiple inputs and outputs simultaneously without assigning arbitary weights and does not require the use of homogeneous measurement units nor a prespecified functional relationship between inputs and outputs, especially in not-for-profit entities. This paper applies DEA to the assessment of the performance of Taipei regional hospitals and suggests a conceptual framework for the treatment of factor weights in DEA. Then,it develops and and presents alternative methods to limite the ranges within which these multipliers are allowed to vary. This research also provides a new approach for controlling factor weights, named AFSAB by author. All of these methods involve additional information which is taken into the analysis in the form of bounding constraints and different objective functions. Finally, the implications of the various approaches is discussed below.