Wang J Y, Ko Y C, Wang J W, Jan L C, Chang F M, Lin K C
School of Public Health, Kaohsiung Medical College, Taiwan, Republic of China.
Kaohsiung J Med Sci. 1996 Dec;12(12):737-45.
Even more restrictive regulations and reimbursement limits seem to be a very heavy burden and stress for most provincial hospitals, especially after the National Health Insurance System has been introduced. The purpose of this project to find a better, universal direction for these hospitals through three steps: 1) Using different financial and accounting ratio indexes to evaluate the general business performance of each hospital. 2) Taking a comprehensive questionnaire with senior managers of each hospital to know their concepts and attitudes concerning external environment and internal operation. 3) Comparing data's correlation and differentiation to ascertain better trends for future operation for all hospitals. The database for this project comes from two resources: 1) Government finance and budget reports of 22 provincial hospitals for the 1994 accounting calendar year. 2) The results of questionnaires returned by 274 senior managers of hospitals, and analysis of these by chi-square test. Through statistical comparison, a number of conclusions can be made: 1) Most hospitals have better operation efficiency if any professional hospital administrator is working for them. 2) The hospital with more comprehensive personnel system shows better business performance. 3) The hospital with routine and formal financial analysis reports always has better business performance. 4) The hospital with poor operational efficiency tends to get rid of restriction or limitation from government's system. 5) The hospital with good operational efficiency has more confidence and desire to improve and change. 6) The hospital with poor operational efficiency is more dependent on outside support from government. 7) The hospital with better business performance has more concern about the impact of malpractice around the hospital. In short, a hospital with poor business efficiency always has more pessimistic attitude and tends to rely on outside resource support. On the other hand, a hospital with more confidence, flexibility and readiness for internal improvement always demonstrates greater business efficiency.
对于大多数省级医院而言，愈发严格的规章制度和报销限制似乎是极为沉重的负担和压力，尤其是在国家医疗保险制度推行之后。本项目旨在通过三个步骤为这些医院找到一个更好的、通用的发展方向：1）运用不同的财务和会计比率指标来评估每家医院的总体业务表现。2）对每家医院的高级管理人员进行全面问卷调查，以了解他们对外部环境和内部运营的理念与态度。3）比较数据的相关性和差异性，以确定所有医院未来运营的更好趋势。本项目的数据库来自两个来源：1）22家省级医院1994会计年度的政府财政和预算报告。2）274位医院高级管理人员返回的问卷结果，并通过卡方检验对其进行分析。通过统计比较，可以得出一些结论：1）如果有专业的医院管理人员为其工作，大多数医院的运营效率会更高。2）人事制度更完善的医院业务表现更好。3）有常规且正式财务分析报告的医院业务表现往往更好。4）运营效率低下的医院倾向于摆脱政府制度的限制。5）运营效率高的医院更有信心和意愿进行改进与变革。6）运营效率低下的医院更依赖政府的外部支持。7）业务表现较好的医院更关注医院周边医疗事故的影响。简而言之，业务效率低下的医院总是态度更为悲观，且倾向于依赖外部资源支持。另一方面，更有信心、灵活性且准备好进行内部改进的医院总是展现出更高的业务效率。
