醫院品質管理活動數量與績效關係之研究

Background and Purpose: After the implementation of the National Health Insurance in Taiwan in 1995, the competition among hospitals in Taiwan increased dramatically. Therefore, for attracting more patients, many hospitals invest a lot on many quality management activities, such as TQM, QCC, development of clinical pathway, ISO standards, suggestion system, reengineering, 5S, EBM, learning organization, six sigma, QIP, etc. However, no empirical study has been conducted for examining the relationship between quality management activities and hospital performance. Thus, this study examined the relationship between number of quality management activities and hospital performance longitudinally. Methods: The study samples include 128 regional (and above) teaching hospitals in Taiwan. A questionnaire was sent to each hospital for collecting related information. The response rate was 54.68%. All the data collected was linked to the National Hospital Survey conducted by the Department of Health, the Executive Yuan for analysis. Hospital performance was represented by DEA (data envelopment analysis) scores. GEE (Generalized Estimating Equation) regression was applied to analyze the longitudinal impact of number of quality management activities on hospital performance. Results: (1) The Quality indicator project and clinical pathway are the most popular quality activities in Taiwan now. (2) The more the hospital quality management activities, the higher the physician productivity and hospital performance. Conclusion: In conclusion, the results proved that number of quality management activities have positive effects on hospital performance. In other words, promoting health care quality will lead to better hospital performance. Therefore, we suggest hospital administrators to design a long term plan to promote quality management activities continuously.