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    Title: 總額支付制度實施後醫院經營績效之探討
    Other Titles: The performance efficiency of hospital after the global budget system
    Authors: 鄭棨隆;Cheng, Chi-Lung
    Contributors: 淡江大學會計學系碩士班
    韓幸紋;Han, Hsing-Wen
    Keywords: 資料包絡分析法;總額支付制度;經營績效;醫院;DEA(Data Envelopment Analysis);The Global budget system;Performance Efficiency;Hospital
    Date: 2015
    Issue Date: 2016-01-22 14:55:25 (UTC+8)
    Abstract: 本研究主要目的在探討2002年7月1日醫院於總額支付制度實施後,其經營績效的變化,為避免醫院於總額實施前已因應調整行為及SARS疫情影響,且選取醫院總額影響為完整年度,本文以健保申報資料分析2000年及2004年共376間醫院為樣本,利用資料包絡分析法(data envelopment analysis, DEA)做為績效評估模式,以DEA的CCR模式進行醫院效率分析,主要依變項為效率值,本文分為三種模式進行分析:(1)純服務量、(2)純醫療品質以及(3)服務量加醫療品質,並控制醫院主要特性,再以Tobit截斷迴歸分析探討總額實施對醫院經營效率之影響。
    研究發現,實施總額支付制度,醫院的服務量績效顯著提升,醫療品質績效有顯著但些許下降。若以t檢定觀察醫院各投入產出項於總額實施前後之差異,發現醫院醫療品質顯著下降。結果顯示,總額制度箝制醫院財源而醫院不得輕易拒絕病人之情況下,可能以犧牲醫療品質方式來因應。
    This study aims to explore the change of hospital performance efficiency, after the global budget system. To avoid hospitals response adjusted behavior before the global budget system and impact of the SARS, we selected a sample of 266 hospitals in year 2000 and 2004. Use data envelopment analysis (DEA) to evaluation hospital performance. The CCR model is employed to analyze hospital performance, divided into three modes for analysis: (1) the services volume, (2) medical quality, (3) the services volume and medical quality. Tobit regression analysis to explore the impact hospital performance after global budget system.
    The study found that in short-term hospital service volume performance does not significantly reduce, medical quality performance has a little declined. The result of the research showed the hospital financial resources limit the global budget system, hospital probably at the expense of medical care quality approach to cope while hospital can’t easily refuse a patient
    Appears in Collections:[會計學系暨研究所] 學位論文

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