||With the initiation of national health insurance, the ecology of medicine and organization of hospitals in Taiwan underwent rapid change. The beginning of a global budget aggravated the impact of hospitals, especially the district hospitals which were already facing most of the pressure. Over half (51.61 %) of the above district hospitals chose to focus on long term care, nursing homes making up the great majority. |
This research evaluates the efficiency of two district hospital-based nursing homes by Data Envelopment Analysis (DEA). The purpose of this research includes:
First, evaluate the efficiency of two district hospital-based nursing homes, including overall efficiency, purely technological efficiency and scale efficiency. Second, assess the relative efficiency relationships of the two nursing homes. Third, probe the differences between relatively efficient and relatively inefficient groups in input variable and output variable. Fourth, with the analysis results, suggest adjustments of input and output to every relative inefficiency groups, as the health care manager's reference.
The research approach is to consult relevant documents and the purpose of this study is to choose input and output variables. These variables are screened by Pearson analysis for isotonicity relation. Process the study by DEA for relatively efficient analysis, then direct against the relatively inefficient groups for discussion of efficiency reference set and slack variable analysis.
The result of study shows:
First, overall efficiency: There are 6 relatively inefficient groups (37.5%) in the first nursing home; There are 8 groups relatively inefficiently attended to (50%) in the second nursing home; There are 18 groups relatively inefficient (56.25%) in the combined first and second nursing home groups.
Second, purely technological efficiency: There are 4 groups relatively inefficiently attended to (25.0%) in the first nursing home; There are 5 groups relatively inefficiently attended to (31.25%) in the second nursing home; There are 15 groups relatively inefficient (46.9%) in the combined first and second nursing home groups.
Third, scale efficiency: There are 6 groups relatively inefficiently attended to (37.5%) in the first nursing home; There are 8 groups relatively inefficiently attended to (50%) in the second nursing home; There are 18 groups relatively inefficient (56.25%) in the combined first and second nursing home groups.
Fourth, the slack variable analysis: the input items that must improve are foreign caretaker labor hours, nurse assist labor hours and nurse labor hours into sequentially, the output one is most important in increasing the income range.
In this research, nursing staff and attendants' labor hour can only represent the workforce attending to the unit, but besides personnel figures, personnel quality is a very important factor, too; as regards nursing efficiency, it is not only the number attending to the quantity of service, but also the quality: For example, the incidence of pressure sores, unexpected accidents, patient satisfaction, or staff members' satisfaction, etc. These will all influence the overall efficiency in DEA and remaining research to analyse further in the future. We hope the parameters, such as the make up of resident people in different areas, severity of disease, etc., could continue relevant research to influence the efficiency of nursing homes in the future.