| Summary: | 碩士 === 高雄醫學大學 === 醫務管理學研究所碩士在職專班 === 95 === Abstract
?? Background and Purpose:
The not-for-profit religious healthcare institutions face a great challenge today because of the new National Insurance Policy “Global Budget Cap” and various medical policies changes. These not-for-profit healthcare institutions not only need to continue their missionary services to the needy individuals, but also have to keep up with the competition from the private and public hospitals. Thus, it is important for the not-for-profit religious hospitals to evaluate their operating efficiency, based on their missions and goals, in order to optimize their investment in personnel and capital expenditures. The objectives of this study are: (1) to evaluate the Study Hospital, a Christian hospital, operating efficiency before and after the National Insurance “Global Budget Cap” policy, during 2002 – 2004; (2) to evaluate the Study Hospital’s operating efficiency against the selected religious hospitals within the same operating category; (3) to evaluate the Study Hospital’s operating efficiency against selected religious and private hospitals within the same operating category; (4) to determine how, if possible, to optimize the operating efficiency of the Study Hospital without laying off any personnel.
?? Materials and Methods:
A Christian religious regional hospital located in Pingtong City, was selected as “Study Hospital” for this study. Selected religious and private regional hospitals as well as medical centers were also included in the analysis. Data Envelopment Analysis (DEA) was used as the evaluation method. Four input variables (floor area, total beds, number of doctors, and number of nursing staff) and three output variables (daily outpatient visits, daily emergency room visits, and average bed occupied rate) were used for DEA. The hospital data was extracted from the “Taiwan Hospital Annual” between year 2002 – 2004 by Taiwan Hospital Association.
?? Results:
There are one Study Hospital (in Pingtong City), 9 religious regional hospitals, and 8 private regional hospitals. The results showed that the Study Hospital has the best operating efficiency in 2002 while 2003 yielded the worst efficiency. Among religious regional hospitals, 4 hospitals have better efficiency before the implementation of global budget cap policy. Four hospitals have better efficiency in 2004 which as after the implementation of global budget cap policy. Among regional hospitals which were relative efficient (Efficiency = 1), 10 DMUs were religious hospitals and 9 were private hospitals. Among hospitals which were relative non-efficient (Efficiency <0.8), 5 DMUs were religious hospitals and 3 were private hospitals. Most hospitals included in this study exhibited lowest operating efficiency in 2003. If the effect of SARS was considered as a cause of decrease of average bed occupied rate, the adjusted efficiency still demonstrate that 2003 yield the worst efficiency which suggest the influence of global budget cap.
?? Discussion and Conclusion
Based on our study, the Study Hospital exhibited “above average” operating efficiency against other religious regional hospitals. However, religious regional hospitals, in overall, did not perform better than private regional hospitals. Our results also indicate that the global budget cap policy has impact on most of the hospitals in 2003 which yielded the lowest operating efficiency. It is noteworthy that some hospitals regain their competitiveness where their efficiency increases in 2004. It is possible to design a prospective, qualitative study to determine the key aspects to achieve high operating efficiency in better performance hospitals in the future.
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