The Performance Efficiency of Hospitals of Department of Health after Implementation of Global Budget

本研究探討民國88-93年度全國20家綜合型著立醫院的營運效率，分析6個年度120個 決策制定單位(Decision Making Unit, DMU)，本研究以資料包絡分析法(Data Envelopment Analysis, DEA)做為績效評估模式，DEA能包絡多項投入與產出，而演 算出相對效率模式。本研究以醫師、醫技人員、護理人員、行政人員、總病床數、醫 療成本、管理費用與政府補助款等八種為投入項目，以門診人次、急診人次、住院人 日數、佔床率、醫療收入與業務外收入等六種為產出項目，研究顯示出署立醫院120 個DMU在整體效率值(0.9388)、技術效率值(0. 9538)、規模效率值(0.9840)來看，醫 院經營上大都具備效率。依各醫院別觀察可知署立醫院於88-93年間，各醫院整體效 率、技術效率與規模效率皆有顯著差異。在整體效率上，F醫院、G醫院與H醫院表現 顯著高於L醫院。在技術效率上，F醫院、G醫院、H醫院與E醫院表現顯著高於L醫院。 在規模效率上，F醫院與H醫院表現顯著高於J醫院。但依總額預算前後觀察可知實行 總額預算後，未必會造成署立醫院經營競爭力下降。進一步藉由差額變數分析，可以 更清楚的顯示各DMU資源使用情形及改善空間。若依據差額變數表，醫院可針對投入 產出變項進行調整而達到改善的目標，即成為有效率的單位。 This study uses data envelopement analysis to investigate the performance efficiency of the 20 hospitals of Department of Health (DOH), Executuve Yuan during the year of 1999 to 2004 . We selected doctors, medical staffs, nurses, general staffs., total beds, cost of medical treatment, administration expense, government subsidy as input variables, and patients of admission, emergency, visit numbers of OPD patients, occupation rate of beds, income of medical treatment, non-medical income as output variables to calculate the relative efficiency. As a result, the overall efficiency is 0.9388 and the pure techical efficiency is 0. 9538 and scale efficiency is 0.9840 within 120 DMU of DOH. There were different performance efficiency of the 20 hospitals of DOH during the year of 1999 to 2004. But there were no different performance efficiency before or after implementation of global budget. It implies that global budget does not affect the performance of DOH hospitals. We use slack variable analysis to show each DMU's utility of resources. According to slack variable table, hospitals can adjust the input or output variables to become a more efficient unit.