醫院管理指標的性質與應用

The Nature and Application of Hospital Management Indicators

醫院為了評估本身的能力和引導改革的方向，快速而科學的方法之一，即是藉由管理指標的建立與對指標持續的監控來達成，而且管理指標必須涵蓋多重面向在內，才能對醫院管理做一全面性的監測與改善。本文係在透過國內外醫院管理指標發展現況的綜合整理，將之分成服務投入、產出、品質、經營效率、系統整合等五大類，並對指標的取向、主題、測量方法等加以分析比較，提出可供參考採行的建議指標，以及選用指標時考量的條件等，本文所提出的分析性架構，並可作為未來更進一步研究的基礎。醫院管理指標是手段而不是目的，使用管理指標的精神，在於藉由醫療院所對其自身的各項服務績效表現，做一系統化長久性的監測，已達持續改善的目的，同時建立一個院際間可相互比較的指標系統。不但有助於醫療院所本身提升其內部管理的效能，將來部份的資訊亦可用於全民健保或HMO體系下的相互比較，達到醫療體系內醫療院所整體性的效能提升。本文建議初期可由性質相近的幾個大型醫院共同建立一可比較的指標系統資料庫，俟系統發展成熟後可以擴大到不同層級的醫療院所，未來應可建立跨院所的醫院管理指標系統。

Establishing and continuous monitoring of indicators is one of the fast and scientific method for hospitals to evaluate their abilities and direct their improvements. The hospital management indicators should be multi－dimentional in order to monitor and improve performance comprehensively. The purpose of this article is to explore currently used indicators of hospital management. The indicators were classified into five categories: input, output, quality, efficiency, and system integration. The orientation, purpose, method of analysis, strengths and weaknesses of the indicators were compared. Some indicators were suggested to be adopted by the hospitals. Using the hospital management indicators is not the goal but means. The purpose of using hospital management indictors is to do a monitoring for continuous improvement by the hospitals. To construct a comparable indicator system is helpful to the management and operation of hospitals. Part of the information is also useful for the National Health Insurance Program or Health Maintenance Organization systems. Constructing a comparable indicator databank by some large hospitals at the beginning stage was suggested. After the system being developed maturely, the cross-leveled hospital management indicator system could be set up subsequently.