以商業智慧方法論分析臺灣健保體系下醫事人員流動趨勢

A Business Intelligence Approach to the Analysis of Career Mobility of Medical Professionals in Taiwan

人力資源管理是企業經營的核心能力之一，在勞力密集的醫療產業更是如此，國外研究指出，醫事機構內的工作人員的工作壓力越大，其滿意度會越低，相對的離職意圖會增加，而人員的流動會影響組織的財務收入，病人的滿意度及整體營運，對組織的經營產生不利的影響。然而，國內目前並沒有分析醫事人員流動趨勢的研究。巨量資料的時代已經來臨，企業如何藉由商業智慧分析工具將大量且複雜的數據進行切割、鑽取，並且能夠迅速產出有用及正確的資訊，提供經營管理者制定決策的依據，也是一大挑戰。我們利用健保資料庫「基本資料檔」中的「醫事機構基本資料檔」與「醫事人員基本資料檔」，以商業智慧概念建構一套台灣地區醫療人力資源線上分析系統，可以從不同面向探討每家機構醫事人力以及離職率的情況。研究結果顯示2007~2011年間特約藥局與基層診所的家數有顯著的成長，特別是在臺北縣（現為新北市）、臺北市及桃園縣。2010年的資料顯示，「地區醫院」、「慢性醫院」及「臺南市」的藥師離職率顯著高於其他類型醫院。另外，「地區醫院」與「慢性醫院」的醫事人員平均流動率高於其他類型醫院，建議後續可針對醫事人員離職率較高的醫事機構深入探討原因。我們也建構了台灣地區醫事人員離職率視覺化儀表板，提供經營管理者參考。

Human resources management is one of the core competencies for business management, especially in a labor-intensive medical industry. The research showed that the greater pressure the medical staffs have in the medical institutions, the lower their satisfaction is, relatively representing that their intention to quit the job will increase. The employee turnover rate will affect the organization's income, patient satisfaction and the overall operations, resulting in negative impact on the organizational management. However, currently there is no research aimed at the turnover rate of healthcare professionals in Taiwan. The era of big data has come. How the enterprises slice and drill down large amounts of complex data by utilizing business intelligence analysis tools, which can quickly output useful and accurate information to assist the management in the decision making process, is also a big challenge. We use ＂registry for contracted medical facilities＂ and ＂registry for medical personnel＂ from registration files in the National Health Insurance Research Database (NHIRD) to construct online analysis system of Taiwan's medical human resources based on the concept of business intelligence. This online system can explore medical manpower and the turnover rate of employees in each medical institution from multidimensional aspects, analyze the difference in the turnover rate of healthcare professionals among medical institutions at different levels. The results showed that between 2007 and 2011 there were a significant growth in the number of contracted pharmacies and primary care clinics, especially in Taipei county (now renamed New Taipei city), Taipei city and Taoyuan county. The data in 2010 showed that the turnover rate among pharmacists in regional hospitals, chronic hospitals and Tainan city was significantly higher than that in other types of hospitals, while the turnover rate among healthcare professionals in regional hospitals, chronic hospitals was also significantly higher than that in other types of hospitals. We suggested that the identification of the causes can be further discussed in the follow-up study concerning medical institutions with higher turnover rate of healthcare professionals. In our study, to assess the turnover rate of healthcare professionals in Taiwan, visual analytic dashboard was developed, which can provide the references for managers.