公立醫院經營績效分析－－以某南部地區醫院為例

Case Analysis on Operating Performance of Public Hospitals-Take a District Hospital as an Example

近年來隨著經濟之成長，民眾對於醫療服務水準的要求日益提高，加上大型財團法人醫院的興起及全民健保的開辦，使得我國醫療產業的競爭日趨激烈，尤其公立醫院肩負特殊任務及目的，其經營績效不能全以營利為考量，因止受到的衝擊更大。為了瞭解影響醫院經營績效的因素，本研究以南部某地區專科教學醫院為研究對象，收集該院92年至97年每月財務報表及服務量報表次級資料，運用多元迴歸分析法作－－實證陸之分析，探討醫療服務品質、生產力、及財務三種經營績效指標之問的相關性，期能提供醫療機構管理者提昇經營績效的管理方向。在分析過程中，為了純化所探討的三種經營績效指標之間的關係，採用教學醫院評鑑合格和實施平衡計分卡二個控制變數。本研究結果顯示，生產力愈高，醫療服務品質愈高，然而此時院內感染率也提高，因此應加強院內感染的預防措施，以避免院內感染率升高，損及醫療服務品質。其次，個案醫院的收入主要來自住院病人，但是住院超過三十天率對住院收入有負面影響，故應該避免非必要的超長期住院。影響財務績效面的生產力因素主要為占床率，醫院可以從提高占床率著手，藉由增加醫療收入，提高財務績效，進而達到提升經營績效之目的，惟相對的需要投入較多醫療資源，使得藥品成本與衛材成本亦隨增加。

Along with the growth of economics, people have paid more attention on the healthcare, and then the establishment of large hospitals and the adoption of national insurance system severely impact the health care industry. Public hospitals usually serve a special purpose and then do not aim to make profit as its first priority. Nevertheless, they still need adequate profit to provide qualified healthcare service. This study aims to investigate the operational performances of hospital, and to find the relationship among the healthcare service quality, productivity, and financial performance, using monthly data of a public hospital in southern Taiwan. Empirical study shows that productivity is positively con elated to healthcare service quality and financial performance. In this study, the importance of occupancy rate and average length of stay is greater than that of other measure indicators of operational performance.