The study on the relationship between hospital attributes and service efficiency by physicians and nurses in Taiwan's hospital
| Autor: | Yu-Ju Kuo, 郭郁如 |
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| Rok vydání: | 2013 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 101 Objective With implementation of global budget policy of Taiwan National Health Insurance the issues of physician and nurse workforce were greatly concerned in recent years. The shortage of physician and nurse workforce in various healthcare subspecialties has a great impact on the medical quality and healthcare efficiency. The aims of this study have first, to investigate the relationship between physician or nurse staffing and service efficiency, and second, to find the impacting factors on service efficiency in Taiwan’s hospitals. Methods The study was a retrospective, longitudinal analysis. A total of 707 hospitals from 2001 and 2010 were enrolled for analysis. The hospital characteristics including ownership of hospital, teaching status, hospital bed numbers and number of high-tech equipment, such as computed tomography (CT), magnetic resonance imaging (MRI), radiation therapy, nuclear medicine and positron emission tomography (PET) were used as predicting variables. The service volume including admission, outpatient and emergency service were used as dependent variable. All the data were retrieved from the annual report dataset of Department of Health, Taiwan. Statistical analysis including descriptive statistics and inferential statistics were performed using SPSS 18.0 software. The data envelope analysis (DEA) were used to evaluate the hospital service efficiency. Generalize estimating equation (GEE) model was used for longitudinal analysis to study the relationship between hospital attributes and service volume by using STATA 11.0 software. Results The results showed that teaching hospitals had larger scale and more service volume than non-teaching hospital. The hospitals with larger scale have more high-tech equipment. The result of DEA analysis showed hospitals with higher number of beds had a higher efficiency score than those with less bed numbers. The GEE mode analysis showed that the major impact factors of service efficiency were the number of high-tech equipment, hospital bed number and teaching status. There was no significant difference between public and private hospitals. Conclusion Hospitals with different attributes have various service efficiencies by physicians or nurses. The major variables affect service volume by physicians or nurses including hospital bed numbers, teaching status and the numbers of high-tech equipment. Our results provided evidence on the association between physician or nurse workforce and service efficiency for human resource management in Taiwan’s healthcare service under NHI. Further studies are needed to answer the association between healthcare workforce and medical outcomes or quality. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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