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研究生:李宜柔
論文名稱:署立醫院經營績效評估之研究
論文名稱(外文):A Performance Study of Public Hospitals in Taiwan
指導教授:孫遜孫遜引用關係
學位類別:碩士
校院名稱:佛光大學
系所名稱:管理學系
學門:商業及管理學門
學類:財務金融學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:中文
中文關鍵詞:資料包絡分析績效評估署立醫院生產力成長
外文關鍵詞:Data Envelopment AnalysisPerformance MeasurementPublic HospitalProductivity Growth
相關次數:
  • 被引用被引用:14
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本研究旨在探討民國93年至96年間21家署立醫院經營績效、生產力變動趨勢及環境變數對績效之影響。本研究首先使用資料包絡分析法中產出導向的確定區域模式評估署立醫院的整體績效及個別績效(產能績效與醫療績效),再採交叉模式找出最佳績效之醫療院所,並運用麥氏生產力變動指數來分析跨期生產力變動趨勢,最後以廻歸分析來檢視環境變數對營運績效之影響。
研究問題包含:(1) 探討署立醫院之整體績效及個別績效(產能績效與醫療績效)為何?;(2) 探討署立醫院規模報酬為何?;(3) 探討具有最佳整體績效與個別績效的署立醫院分別為何?;(4) 探討署立醫院其整體績效與個別績效的關係為何?;(5) 探討署立醫院跨期生產力變動趨勢為何?與 (6) 探討環境變數對署立醫院經營績效影響為何?
本研究發現:(1) 署立醫院平均整體績效為0.656,平均產能績效為0.655,平均醫療績效為0.566;顯示仍有相當大的改善空間;(2) H4、H6、H7、H12及H14醫院四年皆處於最適生產規模,其餘醫院大多需要增加醫院規模,而少數醫院需縮減其醫院規模;(3) 整體績效表現最佳的的醫院為H6;產能績效表現最佳的醫院為H4,醫療績效表現最佳的醫院為H1;(4) 有高整體績效的醫院也會有較高的產能績效;(5) 11家醫院之總因素生產力呈現成長的趨勢,平均成長了1.8%;(6) 各縣市每平方公里人口數對署立醫院之整體績效有顯著的正向影響。
The purpose of this study is to assess overall performance, and productivity change of the 21 selected public hospitals of Department of Health in Taiwan over 2004-2007, and examine the effects of environmental factors on the hospital performance. The study used output-oriented assurance region analysis DEA to assess the overall performance, capacity performance, and operational performance of these public hospitals. This study employed cross efficiency measure to identify best practice, used Malmquist index to estimate productivity change over a four-year period, and finally utilized regression analysis to examine effects of environment variables on hospital performance.
Research questions include: (1) How well do the sampled public hospitals perform in terms of overall, capacity, and operational performances? (2) What returns to scale were the sampled public hospitals experienced? (3) Which were the best practice public hospital in terms of overall, capacity, and operational performances? (4) What is the relationship among overall, capacity, and operational performances? (5) What productivity change did the sampled hospital perform? and (6) What are the effects of environmental variables on the effectiveness performance of the sampled public hospitals?
Results of this study show: (1) Mean overall performance, capacity performance and operational performance of the selected hospitals are 0.656, 0.655 and 0.566, respectively ; (2) H4, H6, H7, H12 and H14 was experienced constant returns to scale, others need to downsize or expand their operating scale of size ; (3) H6 is the best practice in overall performance, H4 is the best practice in capacity performance, and H1 is the best practice in operational performance ; (4) A hospital with high level of overall performance intends to have a high level of capacity performance ; (5) In average, 11 hospitals had positive productivity growth ; and (6) Population density has positive impact on the overall performance of the hospitals.
摘要 i
Abstract ii
目錄 iii
圖目 iv
表目 v
誌謝 vi
第壹章 緒論 1
第一節 研究背景 1
第二節 研究動機與目的 3
第三節 研究問題 6
第四節 研究方法 7
第五節 研究範圍與限制 8
第六節 研究內容 9
第貳章 文獻探討 11
第一節 非DEA應用文獻 11
第二節 DEA應用文獻 18
第三節 DEA理論文獻 36
第四節 文獻小結 44
第參章 研究方法 45
第一節 研究流程 45
第二節 研究設計 47
第肆章 實證分析 59
第一節 績效分析 59
第二節 生產力變動趨勢分析 68
第三節 環境變數分析 70
第四節 管理意涵 71
第伍章 結論與建議 73
第一節 結論 73
第二節 建議 73
參考文獻 75
附錄 80
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1. 王媛慧、李文福 (民87),台灣地區公私立醫學中心與區域醫院生產力變動之研究-無母數Malmquist指數之應用,經濟論文,26(3),243-269。
2. 王媛慧、李文福 (民87),台灣地區公私立醫學中心與區域醫院生產力變動之研究-無母數Malmquist指數之應用,經濟論文,26(3),243-269。
3. 朱文洋、葉淑娟 (民90),中小型醫院經營策略與營運績效之探討-以平衡計分卡觀點分析,醫務管理期刊,2(2),109-138。
4. 朱文洋、葉淑娟 (民90),中小型醫院經營策略與營運績效之探討-以平衡計分卡觀點分析,醫務管理期刊,2(2),109-138。
5. 孫遜 (民92),台北市立綜合醫院營運績效評估之研究,管理學報,20(5),993-1022。
6. 孫遜 (民92),台北市立綜合醫院營運績效評估之研究,管理學報,20(5),993-1022。
7. 陳韻靜、郭乃文、黃國哲 (民92),醫院策略型態與績效評估指標之相關性探討-以平衡計分卡觀點分析,醫務管理期刊,4(4),91-110。
8. 陳韻靜、郭乃文、黃國哲 (民92),醫院策略型態與績效評估指標之相關性探討-以平衡計分卡觀點分析,醫務管理期刊,4(4),91-110。
9. 陳世能 (民95),醫學中心與區域醫院生產力變動之研究-含服務品質之Malmquist指數bootstrap方法,醫務管理期刊,7(1),57-80。
10. 陳世能 (民95),醫學中心與區域醫院生產力變動之研究-含服務品質之Malmquist指數bootstrap方法,醫務管理期刊,7(1),57-80。
11. 蔡文正、龔佩珍、翁瑞宏、郭娓吟 (民94),以平衡計分卡建構公立醫院經營績效評估指標,醫院,38(5),44-57。
12. 蔡文正、龔佩珍、翁瑞宏、郭娓吟 (民94),以平衡計分卡建構公立醫院經營績效評估指標,醫院,38(5),44-57。
13. 楊啟鈿、錢慶文 (民92),以資料包絡法評估榮民醫院之經營效率,醫院,36(3),24-33。
14. 楊啟鈿、錢慶文 (民92),以資料包絡法評估榮民醫院之經營效率,醫院,36(3),24-33。
15. 潘奇、魏誠佑、祝道松、侯勝茂 (民95),總額預算實施前後署立醫院營運績效之評估,醫務管理期刊,7(4),403-416。