近年來在競爭的醫療環境下，且面對健保支付制度之改變，如何有效衡量及提昇經營績效，實為醫院經營者重要之課題。本研究以某醫學中心各臨床部科進行個案研究，分為內科組13個臨床科與外科組12個臨床科，以資料包絡分析法之麥氏生產力指數、CCR與BCC模式分析，針對個案醫院臨床部科於醫院總額預算實施前後相對經營績效變化，以及長期經營績效進行評估，期能提供醫院經營管理者建立有效率的經營管理參考。 研究結果發現，內、外科組在總額預算實施後之生產力呈現衰退趨勢，主因為生產技術衰退所導致，純技術效率與規模效率於總額預算實施後則多呈現上升趨勢。在長期經營績效部分，不管分年度或取六年平均值，內科組有3個臨床部科屬相對有效率單位，5個臨床科屬相對無效率單位；外科組有2個臨床部科屬相對有效率單位，4個臨床部科屬相對無效率單位。整體而言，結果顯示總額預算實施的確達到抑制成本的目的，使個案醫院之經營效率提升，然而醫療技術則有衰退的現象。 本研究在績效評估中特別加入醫療品質指標，結果發現品質指標會顯著影響效率值，因此在評估醫院績效時，建議加入品質指標以使效率評估更為完善。 Under competitive medical care environment and the change of health insurance system in recent years, how to effectively measure and promote operational performance is an important topic for the management of hospitals. Using a medical center as a case hospital, this study applies Malmquist Productivity Index (MPI), CCR model, and BCC model of Data Envelopment Analysis (DEA) to examine the impact of Global Budget System on the operational performance of 13 internal medicine divisions and 12 surgical divisions. This study also evaluates the long-term operational performance among different clinical divisions. The empirical results show that the productivity of clinical divisions presents decline trend after the implementation of Global Budget System. The main reason is the regression of technique. Nevertheless, pure technique efficiency and scale efficiency present rising trend. Regarding the long-term operational performance, 3 clinical divisions are relatively efficient while 5 clinical divisions are relatively non-efficient for internal medical group. For surgical group, 2 clinical divisions are relatively efficient units while 4 clinical divisions are non-efficient. All in all, the results indicate that the implementation of Global Budget System has a positive impact on cost constrain. However, the medical technique shows a deterioration phenomenon. This research also adds medical treatment quality indicators in performance evaluation. The results indicate that quality indicators significantly influence the value of efficiency. Therefore, in order to establish comprehensive performance evaluation, this study suggests that management consider quality indicators when evaluating the operational performance the clinical divisions of hospitals.
