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研究生： 温文熙
Wen-Shi Wen
論文名稱： 臺灣內兒科診所經營績效分析與特色
The Determinants and Features of the Operational Performance of Taiwanese Internal Medicine and Pediatric Clinics
指導教授： 張順教
Shun-Chiao Chang
口試委員: 賴法才
Fav-Tsoin Lai
張光第
Guangdi Chang
學位類別： 碩士
Master
系所名稱： 管理學院 - 企業管理系
Department of Business Administration
論文出版年： 2018
畢業學年度： 106
語文別： 英文
論文頁數： 64
中文關鍵詞： 縱橫資料 、Hausman檢定 、診所績效 、總額支付制度
外文關鍵詞： Panel data, Hausman test, IMP clinics performance, Global Budget System
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  •  上一筆

    • 本研究資料採用健保資料庫、內政部統計處及中華民國統計資訊網自1998年至2012年間的資料，並以縱橫資料迴歸模型應用探討影響台灣內兒科診所經營績效之因素。本研究同時利用BP-LM Test、Hausman Test 及 Over-Identification Test of Hausman-Taylor Model (HTM) 篩選合適的實證模型。
    實證結果發現顯示，診所內的醫生數、護士數及其他醫療人員數皆對診所的總點數有顯著正向影響，表示這些醫療人員的數量多寡在診所內皆扮演重要的角色，對於診所營運有所助益。此外，除了診所內部可控制的變數外，外部環境因素也至關重要，研究顯示人口老化對診所營運帶來正向影響，而在實施總額支付制度後，對診所的總點數也顯著正相關，雖然該制度是為了減少醫療總支出，但診所為了獲利，提升了醫療服務量來取得更多的健保點數；至於65歲以上人口平均餘命、失業率、可支配所得及發生SARS期間皆對診所的總點數帶來負向影響。
    最後，我們建議內兒科診所業者除了考量上述因素之外，還需克服一些研究限制，方能在競爭激烈的醫療環境中脫穎而出。

    This study explores the determinants of IMP clinics performance using panel data from NHIRD, Taiwan during the period from 1998 to 2012. We utilize the BP-LM test, the Hausman test and the Hausman-Taylor Over-identification test to decide the suitable empirical model.
    The empirical results indicate that the numbers of physicians, nurses and practicing medical personnel have significantly positive impacts on performance of IMP clinics. This situation represents that these medical staff play an important role in IMP clinics for improving the performance. Apart from the clinics interior variables, exterior variables are also essential. For instance, aging problem and Global Budget System implementation have positive effects on total points. Although the purpose of Global Budget System is to reduce expenditure, the clinics devote to provide more medical services to receive more points. In addition, the life expectancy, unemployment rate, disposable income and SARS have negative influences on clinics’ performance.
    Finally, we suggest the IMP clinics may not only concern the above-mentioned factors but also some limitations which this study ignored. Therefore, it can survive well after highly competitive medical environment.

    摘要 i Abstract ii 誌謝 iii Contents iv Table Contents v Figure Contents vi Chapter 1 Introduction 1 1.1 Research Background and Motivation 1 1.2 Research Objectives and Purpose 4 1.3 Research Process 5 Chapter 2 Literature Review 7 2.1 Medical Institutions Performance Measurements 7 2.2 Medical Institutions Performance Determinants 9 Chapter 3 Methodology 16 3.1 Sample Description 16 3.2 Description of Variables 17 3.3 Empirical Model 27 3.4 Methods of Empirical Model Selection 28 3.4.1 Breusch-Pagan Lagrange Multiplier (BP-LM) test 28 3.4.2 Hausman test 29 3.4.3 Over-Identification test of the Hausman-Taylor model (HTM) 32 Chapter 4 Empirical Findings 34 4.1 Testing for Multicollinearity 34 4.1.1 Pairwise Correlation Coefficient Matrix 34 4.1.2 Variance Inflation Factors (VIF) 37 4.2 Empirical Model Selection 39 4.3 Empirical Results 40 Chapter 5 Conclusions and Suggestions 46 References 51

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