考量醫護人力短缺及兼顧醫療品質之醫院經營績效評估模式--以台灣急性照護醫院為例

An Extended DEA Model for Hospital Performance Evaluation Considering Medical Manpower Shortage and Quality of Care: Taking Acute Care Hospitals in Taiwan as Examples

台灣地區之醫院績效評估過去多偏重在經營效率，顯少同時兼顧醫療品質，加上現今醫護人力短缺的問題，傳統的效率評估模型已無法符合現況。本研究應用資料包絡分析法建構兩階段評估模式：階段一建立技術效率評估模式，在現有醫護人力不可減少之限制下，求得各醫院之最佳經營效率；階段二則在階段一之基礎上，再納入醫療照護品質考量，建立綜合效率模式。本次研究之分析數據量涵蓋全國急性醫療照護之大部分數據，研究結果亦高度符合實務現況。針對效率值未臻理想之醫院，本研究提出調整病床配置、增加初診與轉診人數，並提升照護品質等建議。

 

In Taiwan, hospital performance evaluations largely focus on managerial efficiency and rarely on healthcare quality, together with the growing shortage of medical professionals, the conventional performance evaluation models can thus no longer truly reflect current situation. In this context, the authors proposed a practical hospital performance evaluation method based on the data envelopment analysis. The method comprises two stages. During the first stage, a technical efficiency evaluation model was developed to calculate the optimal managerial performance of hospitals, while in the second stage, results from the first stage were incorporated into the analysis of healthcare quality to create a comprehensive efficiency model that conformed to current situations. Hospitals evaluated in this study include medical centers, regional hospitals, and district hospital; data analyzed in this study has encompassed a large portion of the acute medical care of the entire country. The research results and findings of this study accurately match the current situations. For hospitals failing to reach ideal efficiency values, suggestions for adjusting bed configuration were proposed.