本研究以縱橫資料迴歸模型為應用，探討影響台灣地區醫院經營績效之因素。資料採用健保資料庫、中華民國統計資訊網及內政部統計處自1998年至2012年的縱橫資料。同時，本研究利用BP-LM Test、Hausman Test及Over-Identification Test of Hausman Taylor Model (HTM) 篩選適切的實證模型。
實證結果顯示，在醫院可以掌控的內部資源方面，病床數(包含健保床和非健保床)、護士數、醫技人員數、科別總數皆對醫院的總點數有正向的影響，代表這些變數為醫院重要的資產，對地區醫院經營績效的提升有所幫助。然而，醫院為了降低醫生工作負荷或符合評鑑要求而雇用更多的醫生，將引起規模不經濟進而降低醫院總點數。此外，相較於非教學醫院，教學醫院擁有較多資源和名聲，因此教學醫院擁有較好的經營績效。在外部政策與環境的影響方面，實施總額支付制度後，使醫院間陷入囚犯困境，為了維持較好的競爭力和獲取利潤，惟有提升醫療服務量以衝高總點數才是醫院的最佳策略。地區醫院的總點數會隨著扶養比提高而下降，顯示台灣的依賴人口(14歲以下及65歲以上)較少選擇至地區醫院就醫。失業人口容易面臨貧困的問題，和一般就業人口相比，失業人口具有較低的就醫次數和慾望，因此當失業率提高時醫院的總點數會下降。自來水普及率對醫院的總點數存在負向的影響，可以推測高自來水普及率的地區，生活用水的品質較穩定，有效減少因水源衛生問題而引起的疾病，造成就醫的需求減少。

This study mainly investigates the determinants of the operational performance of district hospitals in Taiwan by utilizing a panel regression model together with data for 1,115 district hospitals over the period from 1998 to 2002. The empirical results of the fixed-effects model reveal that the important assets of district hospitals such as the numbers of hospital beds, nurses, medical technology personnel and divisions all have positive impacts on hospital performance, while the number of physicians gives rise to diseconomies of scale. The teaching hospitals are found to have better performance compared to the non-teaching hospitals, due to their better resources and reputations. Furthermore, the district hospitals have faced a Prisoner’s Dilemma since the implementation of the Global Budget system. The main reason for this is that the system causes hospitals to try to provide more medical services and thereby increases the total number of points. Finally, the unemployed population, dependents (people under the age of 15 or over the age of 65) and the penetration rate of running water are not helpful to the district hospitals’ revenue.

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