| 摘要Abstract | 本研究以加入台灣醫療品質指標計畫(Taiwan Quality Indicator Project, TQIP)之 31 家區域醫院為研究樣本,以資料包絡分析法(Data Envelopment Analysis, DEA)及麥氏生產力變動指數(Malmquist Productivity Change Index),對醫院之經營效率進行二階段評估;第一階段為效率評估分析:以 DEA 探討醫療品質因素對加入 TQIP 各醫院之效率影響;第二階段為生產力變動分析:以麥氏生產力變動指數探討各醫院在加入 TQIP 期間生產力及品質變動狀況,並分析其原因。
本研究結果發現:(1)品質變數的加入,會明顯影響醫院之效率變化,因此,在評估醫院之效率時,應加入品質變數,以使效率評估更加完整。(2)加入品質變數後,醫院投入資源的改善幅度,均顯著小於加入品質變數前。(3)TQIP 對生產力及品質之改善反應於第三年,顯示 TQIP 引進之改善效果約遞延二年,符合國際的實施經驗。(4)加入TQIP 後,私立醫院之品質與生產力的改善,均較公立醫院大。Taiwan Quality Indicator Project (TQIP) is a project of measuring and monitoring the medical quality by medical outcome and clinical index. This study examines the efficiency of hospitals joined in TQIP for two parts. By using the Data Envelopment Analysis Model (DEA), we measure the effect of hospitals joined in TQIP whether restricting the quality. Then we use the Malmquist Productivity Index to measure the quality and productivity changes of hospitals after joining in TQIP and analyze the causes of efficiency changing. Our results include: (1) It’s robust method of measuring efficiency and slack variable of hospitals to introduce quality index. (2) The improvement of input resources are lessen after introduce quality index. (3) The hospitals that joined TQIP improve the quality and productivity after joining TQIP on the third year. (4) After joining TQIP, private hospitals improved the quality and productivity better than public hospitals. |