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The entry of large hospitals and corporations into Taiwan's healthcare market has resulted in intense competition for regional hospitals. Over the past decade, the number of medical institutions has decreased, and regional hospitals face challenges in expanding their budgets, manpower, and resources indefinitely. This study examines the operational performance of regional hospitals in central Taiwan, with the results intended to guide managers in adjusting future operational strategies.
This research focuses on 23 regional hospitals in central Taiwan, using financial statements from the National Health Insurance Administration of the Ministry of Health and Welfare for the years 2019-2021. In the first phase, the overall operational performance model was constructed and analyzed using Data Envelopment Analysis (DEA). In the second phase, the Balanced Scorecard (BSC) approach was integrated to evaluate performance across four dimensions, with DEA applied to analyze the individual performance of each dimension.
In the first phase of overall performance evaluation, Decision Making Units (DMUs) 2, 3, 4, 7, 16, and 22 consistently had an efficiency score of 1 over three years, indicating good operational performance. DMU2 was the most frequently referenced, highlighting it as a benchmark for high efficiency and performance. The reference frequency of DMU16 also increased yearly, suggesting its growth and improved performance even during the COVID-19 pandemic.
In the second phase of individual performance evaluation using the BSC approach: 1. Financial Perspective: The efficiency scores of DMU18 and DMU19 decreased yearly due to high management expenses, indicating a need to reduce these costs. DMU23 had the lowest efficiency scores for two consecutive years, requiring management expense reduction to improve performance. 2. Customer Perspective: The efficiency scores of DMU9, DMU11, DMU12, and DMU20 declined yearly, suggesting the need to reduce the number of full-time nursing staff on three shifts and increase the number of outpatient visits to achieve relative efficiency. 3. Internal Processes Perspective:The efficiency scores of DMUs 4, 5, 8, 11, 12, 14, 16, and 18 decreased in 2020 but showed an upward trend in 2021, likely due to the impact of the COVID-19 pandemic delaying chronic disease treatments and reducing hospital admissions, leading to more vacant beds and lower bed occupancy rates.
4. Learning and Growth Perspective:DMUs 1 and 22 were relatively efficient, while DMU4 had the lowest efficiency in 2019-2020 and needed to reduce the number of physicians. The efficiency scores of DMUs 6, 7, and 17 declined yearly, indicating a need to reduce the number of full-time nursing staff on three shifts. Several regional hospitals face operational performance issues in overall performance or within the financial, customer, internal processes, and learning and growth perspectives. It is recommended to improve outpatient and inpatient processes, enhance patient satisfaction, and allocate beds and medical staff reasonably. Financially, optimizing costs and management expenses while increasing outpatient and inpatient revenue is crucial. Additionally, attention should be given to the allocation of physicians and nursing staff, along with increased investment in education and research development, to demonstrate high-quality medical care and enhance operational performance
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