Performance Management of Taiwan’s National Hospitals

Abstract

This study aimed to conduct operation performance evaluations of Taiwan’s national hospitals during the period 2005–2008 and also propose appropriate suggestions for operation performance improvements. 28 national hospitals were selected as study objects and six input variables and three output variables were filtered as evaluation measures. Data envelopment analysis model was used for annual operation performance evaluation, and Malmquist productivity index for intertemporal operation performance change analysis. In addition, a performance scatter diagram and a strategy management matrix were utilized to synthetically analyze all kinds of operation performance data and accordingly improvement suggestions were proposed. Several findings were explored, including (1) nearly 60% of national hospitals ran an inefficient performance; (2) a significant gap between urban and nonurban hospitals did exist in health care resources allocation and medical service outputs, which reflected the negative public opinion about regional medical care resources gap in Taiwan; (3) other evidence depicted the expectation that the government of Taiwan has already wasted a lot of medical resources in the operation of Taiwan’s national hospitals; (4) 70–80% of Taiwan’s national hospitals ran a constant returns-of-scale operation, while the remainder ran a decreasing returns-of-scale operation; and (5) a extreme disparity existed in the total productivity, which rationally conjectured the cause came from the bad operation of several individual national hospitals. At last, two main suggestions advocated: (a) the government of Taiwan should reconsider the medical care resources allocation between urban and nonurban hospitals; and (b) hospital operation performance should be regarded as one of the main prerequisites for government budget subsidies so as to stimulate operation performance improvement and self-sufficiency operation.

Redesigning the Barranquilla's public emergency care network to improve the patient waiting time

“…This could be an explanation of why Availability of specialists -SC19 (34.5%) was ranked second in Human resources criterion. These findings are consistent with , Yeh and Cheng (2016) and Ketabi et al (2018) whose DEA models qualified "number of staff" as a critical input in EDs. Regarding Supplies, medicines and accessories cluster (Figure 7b), Availability of accessories and instrumentation -SC23 was ranked in the first place.…”

“…Such outcomes are an evidence of the regular and poor performance of these EDs in the wild. A similar finding was presented by Yeh and Cheng (2016) who detected that 60% of national Taiwanese hospitals ran an inefficient performance. It is then important to further seek the reasons explaining the aforementioned results.…”

“…This is consistent with Yamani et al (2012) who mentioned that the identification of strengths and weaknesses leads to better planning process and subsequent increased performance in EDs. In parallel, as also recommended by Yeh and Cheng (2016), ED performance can be regarded as a prerequisite for government incentives; thereby, performance improvement and self-efficiency operation can be effectively fostered within the public EDs.…”

“…In their work, 24 ED's of hospitals in Iran were assessed by considering input (4 criteria) and output (4 criteria) factors. A similar DEA application was undertaken by Yeh and Cheng (2016) who assessed the performance of 28 hospitals in Taiwan. In both cases, the approach was also found to be useful for designing focused improvement strategies in the performance of each hospital.…”

Evaluating the comparative efficiency of medical centers in Taiwan: a dynamic data envelopment analysis application

“…Chen's study [ 34 ] showed that public hospitals outperformed non-public ones during the research period even though private hospitals had become larger and more group-oriented. However, Chen [ 35 ] and Yen [ 36 ] found that private hospitals have better technological efficiency than the public hospital. To make a more sophisticated analysis, we classified the ownership into the public, university-affiliated, foundation, and religious hospitals instead of only dividing it into public and private hospitals to reflect real managerial ownership in Taiwan.…”