新設立醫院對鄰近個案醫院初診病患來源之影響

The Impact of A New Hospital on A Neighboring Hospital’s New Patient Encounters in Taichung County

新設醫院往往對鄰近醫院門診量有相當影響，特別是初診病患。初診病患數量是醫療機構服務量是否能夠繼續成長的重要指標，然近年中部地區醫療機構之新設與擴充甚多，醫療機構之病床數成長率相當高，使中部地區的醫療市場競爭加劇，如何爭取到更多客源是醫院生存之維繫關係，因此本研究之目的在探討新設立醫院對鄰近個案醫院初診病患來源影響。本研究以某新醫院設立前後之鄰近個案醫院2005年至2007年初診與複診的病患就醫資料庫及醫院門急診醫療服務利用資料進行統計分析。研究結果顯示初診病患的平均年齡為32.24歲；初診病患的居住區域以台中縣豐原市為主要地區，其次是台中縣潭子鄉與神岡鄉二地區；初診病患佔整體門診百分比從2.80%降至2.59%，再降至2.56%；個案醫院於鄰近新醫院設立前後一年在初診病患的年齡、就醫科別（放射線科及家醫科）與循環系統疾病有所變化。個案醫院來自新設立醫院所在鄉鎮的初診病患人數顯著有下降的趨勢，對於21至30歲及81歲以上兩個年齡別也造成相當程度影響，建議個案醫院應可加強醫院本身醫療市場定位與區隔，爭取年輕與高齡族群客源，如強化鄰近本院但相對遠離新醫院的北部區域客源開拓，中醫及老年專科等部分重點科別之品質競爭應是可行之策略。

New hospitals influence nearby hospitals especially in terms of visits by new patients. The number of first-visit patients is the key to growth of medical facilities. Recently, many hospitals have opened in central Taiwan and the number of medical beds in this area is growing rapidly. Retaining patients in this area has become vital to the survival of hospitals and is the object of this study. This study is based on the database of new patient visits and information about out-patient medical services and emergency patients from 2005 to 2007 at a nearby hospital after the opening of a new facility. We found that the average age of first visit patients was 32.24 and most were from Fengyuan City, Taichung County followed by Tanzi and Shengang Townships. The total of first visit patient dropped from 2.80% to 2.59% and then to 2.56% as the nearby hospital was affected by this new hospital particularly with regard to the patient’s age, medical division, and diagnosis. A significant drop in the number of new patients in a nearby hospital was found after the establishment of the new hospital. The age groups 21 to 30 and 81 and above were most affected. We suggest strengthening market segregation by luring young and elderly patients from within this area. Opening a northern regional patient source and providing Chinese medicine and a specialized division for the elderly could be the best solutions.