A Study on the Relationship between Quality of Health Care and Operating Performance in the Hospitals of the Department of Health
|關鍵字:||醫療品質;經營績效;指標;quality of health care;operating performance;indicators|
Since National Health Insurance in Taiwan began in 1995, to reduce cost has become the common means of pursuing performance owing to the rising fee of health care and difficulty in hospital management. However, the medical service system faces an important issue in fear of sacrificing quality of health care and influencing operating performance with cost constraint. Many studies point out there are some relationships between quality of health care and operating performance, but they deserve further studies. The Hospitals of the Department of Health (DOH) is the largest public hospital system in Taiwan, so it is necessary to analyze its own data to realize the relationship between quality and performance. This study made a research and discussion by collecting the quality and performance indicators of 20 larger hospitals of DOH in 2004. One is for the basis of making relevant policies by DOH; the other is for the strategic adjustment of the hospital management. Findings of this study are presented as follows: 1.The Hospitals of DOH pays much attention to its northern subsidiaries than the southern in hardwares as well as softwares. By comparing with the hospitals in Taipei Medical Region, the doctor productivity of the Hospitals of DOH is relatively efficient and the employee productivity is relatively inefficient. 2.The quality of health care and the service volume and finance of the operating performance show a positive relationship in the hospitals of DOH. The larger a hospital scale and the shorter average hospitalization duration, the higher the service volume and financial indicators of a hospital. 3.The structural quality of health care and the efficiency of the operating performance show a positive relationship in the hospitals of DOH, but a negative one with the productivity. 4.By the results of multiple regression analysis, the operating performance of the Hospitals of DOH is chiefly influenced by structural quality indicators, not process-outcome indicators. Based on the above findings, this study suggests DOH to allocate resources evenly, devote itself to shorten the discrepancy of medical care between different areas, provide people general and objective quality indicators about hospitals by setting up a fair third party, reduce information imbalance in health care system, and protect patients’ medical privilege. The Hospitals of DOH can raise competitiveness and efficiency by simplifying manpower other than doctors. In conclusion, this study proposes that quality of health care can influence operating performance of hospitals. Therefore, it is recommended that the hospital managers should put more emphasis on the promotion of medical care, arrange a specific unit in charge of quality monitor, built up a standard system to earn a competitive advantage.