臺灣博碩士論文加值系統

中文摘要
近年來台灣經濟發展卓越，多元性產業日漸蓬勃，國民消費權利意識提高，隨之對自我健康重視及需求與日俱增。自民國八十四年開辦全民健康保險後，實施總額給付制度，醫療產業環境急劇改變，各級醫院間競爭白熱化，其中整體醫療環境對地區醫院之衝擊最為劇烈，故如何依據醫院條件，並藉由經營管理績效之客觀衡量評估方法，調整經營管理策略突破困境，降低醫療成本提高效益，發展個案醫院獨特性醫療服務，達成醫院經營目標及願景，為醫療機構經營者任務之首。本研究探討地區醫院經營管理績效研究發現幾項論點：
一、本研究整理國內外專家學者之研究結果，設計出「醫院經營管理績效指標量化模式」，分成醫療服務品質指標、生產力指標及財務指標三大構面，來衡量醫療機構之經營績效。
二、依據實證結果及產業分析得知，地區醫院在改善醫療服務品質、提升生產力後，醫療收入產生成長之趨勢，其中醫療服務品質指標及生產力指標與醫療收入之間相關性高於與財務績效指標的相關性，得知改善醫療服務品質與提高生產力，即可創造整體營運績效。
本研究的整體性分析中得知，地區醫院採用績效指標量化模式，可明確發現地區醫院經營困境，運用醫療院所產業分析結果，發現獨特性之優勢，採取合宜經營對策，確實對於地區院產生助益；國內的地區醫院可參考本研究結果，以提升醫院永續經營之目標。

Abstract
In recent years, the economic development of Taiwan has been excellent, diversified industries have become increasingly vigorous, and the consciousness of national consumer rights has raised. As a result, the importance and demand of self-health has increased..Since the National Health Insurance began in 1984, the total payment system has been implemented. The medical industry environment has changed drastically, and the competition among hospitals at all levels has become fierce, in which the overall medical environment has the most severe impact on regional hospitals. Therefore,the first task of the medical institution operator is how to adjust the management strategy to break through the predicament, reduce the medical cost and improve the benefit, develop the unique medical service of the case hospital, and achieve the hospital management goal and vision according to the hospital condition, the objective evaluation method of the management performance. This study explores several arguments in the empirical research of regional hospital operation performance :
1. This study organizes the research results of domestic and foreign experts and scholars, designs the "quantitative model of performance index in hospital management", divides into three aspects of medical service quality index, productivity index and financial index to measure the operating performance of medical institutions.
2. According to the results of empirical analysis, the regional hospital presents an upward tendency in medical income after improving its service quality and productivity.
Among them, the correlation between the medical service quality index and productivity index and medical income is higher than that of the financial performance index, and it is found that improving the quality of medical services and increasing productivity can create the overall operational performance.The overall analysis of this study shows that regional hospitals use the quantitative model of performance index, can clearly find the regional hospital management predicament, and if the use of medical industry analysis results, to find the advantages of uniqueness, to take appropriate management countermeasures, is indeed to help the regional institutions. The regional hospitals can refer to the results of this study, In order to enhance the goal of sustainable management of hospitals.

目錄
中文摘要 ii
Abstract iii
目錄 iv
圖目錄..................................................................................................................................................vi
表目錄..................................................................................................................................................vii
第一章 緒論.........................................................................................................................................1
一、 研究背景與動機.......................................................................................................1
二、 研究目的...................................................................................................................2
三、 論文架構與流程.......................................................................................................2
第二章 文獻探討.........................................................................................................................5
一、 臺灣醫療分級制度及產業環境................................................................................5
二、 醫療院所營運績效及健保醫療財報申報分析.............................................6
三、 醫療產業集中度、醫療資源分布及差距..............................................................13
四、 醫療服務品質..........................................................................................................15
五、 醫院之經營管理策略與績效..................................................................................17
第三章 研究方法.......................................................................................................................22
一、研究變數.................................................................................................................22
二、研究設計....................................................................................................................26
三、統計與迴歸分析........................................................................................................26
第四章 實證分析.......................................................................................................................28
一、績效趨勢分析..............................................................................................................28
（一）醫療服務品質績效..............................................................................................28
1.院內感染率......................................................................................................28
2.平均住院天數、住院死亡率...........................................................................29
（二）生產績效指標......................................................................................................30
1.門診人次、住院人數........................................................................................30
2.急性病房佔床率、急診人次及急性病房住院人日........................................33
（三）財務指標..............................................................................................................35
1.醫療收入及業務成本分析...............................................................................35
2.成本分析..........................................................................................................38
二、相關分析.....................................................................................................................41
三、醫療收入迴歸分析.....................................................................................................46
四、南區某地區醫院對於區域內外產業影響程度.........................................................50
（一）南區某地區醫院簡介........................................................................................50
（二）東臺南地區人口分布、人口結構....................................................................51
（三）南區地區醫院營運收入總額分析....................................................................55
（四）綜合分析............................................................................................................56
第五章 研究結論與建議............................................................................................................57
一、研究結論...................................................................................................................57
二、研究限制...................................................................................................................57
三、研究建議...................................................................................................................57
參考文獻......................................................................................................................................59

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