臺灣醫院配置與技術效率之實證研究

An Empirical Study on the Allocative and Technical Efficiencies of Taiwan’s Hospitals

過去鮮少關注醫院的資源分配問題。若醫院的投入價格扭曲，可能存在資源配置不當，導致經濟效率的損失。本研究旨在衡量臺灣醫院的技術和配置效率，並探究勞動力和資本的投入是否存在過多或不足。在translog影子成本邊界模型下，本研究應用最大概似法同時估計醫院的技術和配置效率。資料取自衛生福利部中央健康保險署公開之醫事服務機構財務報表，資料期間為2013-2017年，共計81家醫院，405筆觀察值。本研究評估臺灣醫院之技術效率和配置效率分別為77.16%和74.50%，其中配置效率低下源於資本的過度使用和勞動力的使用不足。此外，本研究樣本醫院存在規模經濟和範疇經濟。在分類比較中發現，地區醫院之技術和配置效率最高，公立醫院的技術效率高於非公立醫院，而非公立醫院在配置效率方面則優於公立醫院。由於存在配置效率低下，本研究建議醫院管理者應關注醫院的要素投入組合，將有助於提升臺灣醫院的整體經濟效率。

Previous studies have largely overlooked the issue of resource allocation management in hospitals. Distortions in hospital input prices may lead to misallocated resources and economic efficiency losses. This research evaluates the technical efficiency (TE) and allocative efficiency (AE) of 81 general hospitals in Taiwan using balanced panel data from 2013 to 2017. Within the framework of the translog shadow cost frontier model, this study employs the maximum likelihood method to simultaneously estimate both forms of efficiencies. The empirical findings indicate average cost savings of 22.84% and 25.50% attributable to TE and AE, respectively. The results further reveal that allocative inefficiency stems from excessive capital utilization and insufficient labor use. The sample hospitals also benefit from both scale economies and scope economies. Hospital managers are encouraged to enhance their managerial abilities and carefully consider their input combinations to address allocative inefficiencies, thereby improving overall operating efficiency.