Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/27626
標題: 台灣地區老人福利機構經營效率之研究
A Study on th Efficiency Evalustion of Elderly Welfare Institution in Taiwan
作者: 楊惠如
Yang, Hui Ju
關鍵字: Operational efficiency of elderly welfare institution;老人福利機構經營效率;data envelopment analysis;Tobit regression analysis;資料包洛分析法;Toibit迴歸分析
出版社: 應用經濟學系所
引用: 一、中文部分 內政部(2004),九十三年度臺閩地區老人福利機構評鑑作業手冊。 內政部(2005),93年度臺閩地區老人福利機構評鑑報告,內政部。 孫遜(2004),「資料包絡分析法-理論與應用」,揚智出版社。 高強、黃旭男、Toshiyuki Sueyoshi(2003),「管理績效評估-資料包絡分析法」,華泰文化事業公司。 周麗芳、王媛慧(2000),「台灣地區老人照護機構效率之研究」,國立政治大學學報,第八十一期,頁132-156。 陳世能(2002),「台灣地區安療養機構經營效率之分析-資料包絡分析法」,經濟研究,第三十八卷第一期,頁24-53。 宋冀寧、宋麗玉(2001),「社會福利機構服務品質相關因素探討之研究-以老人自費安養護機構為例」,社會政策與社會工作學刊,第五卷第二期,頁175-222。 萬育維、郭登聰、王芯婷(1999),「非營利組織對營利與非營利的看法分析-以老人養護產業為例」,社會發展季刊,第八十五期,頁166-188。 羅紀瓊,石淦生,陳國梁(1996),「醫院效率之衡量-DEA 方法之應用」,經濟論文,第二十四卷,頁375-396。 郭淑珍(2004),「探討台灣地區19家護理之家經營績效」,碩士論文,中國醫藥大學醫務管理學研究所。 王衍智(2000),「廠商多角化生產之決定因素研究-我國電子業之實證分析」,碩士論文,臺灣大學經濟學研究所。 二、西文部分 Fizel J.L. and Nunnikhoven T.S.(1992),“Technical Efficiency of for-Profit and Non-Profit Nursing Homes.” Managerial and Decision Economics,13:429-439. Kooreman P.(1994)“Nursing Home Care in The Netherlands : A Nonparameteric Efficiency Analysis.”Journal of Health Economics,13,335-340. Michael D, Rosko J, Chilingerian A, Jacquelin S.Zinn and William E. Aaaronson. (1995) “The Effects of Ownership , Operating Environment, and Strstegic Choices on Nursing home Efficiency.” Medical Care,33,1001-1021. Nyman,J.A. and D.L. Bricker(1989), “Profit Incentives and Technical Efficiency in the production of Nursing Home Care. ” Review of Economics and statistics,56,586-594. Nyman,J.A.,D.L. Bricker, and D Link(1990), “Technical Efficiency in Nursing Home. ” Medical Care ,28,541-551. Ozcan Y.A., J.J. Cotter(1994),“An assessment of efficiency of area agencies on aging in Virginia through data enevelopment analysis. ” Gerontologist ,34,363-370. Ozcan Y.A., S.E. Wogen,and L.W. Mau(1998),“ Efficiency evaluation of skilled nursing facilities. ”Journal of Medical Systems ,22,221-224. Randy I, Anderson H, Shelton W, Bradley KH, James RW(2003),“Nursing Home Quality, Chain Affiliation, Profit Status and Performance. ” Journal of Real Estate Research,25,43-60. Golany,B.,and Roll, Y.(1989)“ An Application Procedure of DEA,”OMEGA:International Journal of Management Science,17,pp.237-250. Brockett, P. L. and Golany, B. (1996)“Using Rank Statictic for Determining Programmatic Efficiency Differences in Data Envelopment analysis,” Management Science,42,pp.467-472. Sueyoshi, T. and Aoki, S. (2001)“A Use of a Nonparametric Statistic for DEA Frontier Shift: The Kruskal and Wallis Rank Test,” OMEGA: International Journal of Management Science, 29, PP. 1-18. Valdmanis, V.G. (1992), “Sensitivity Analysis for DEA Models: An Empirical Example Using Public vs. NFP Hospitals,” Journal of Public Economics, 48, 185-205.
摘要: 
隨著人口老化速度增加,我國正朝高齡化社會邁進,老人撫養問題將衍生新的社會需求。在老人照顧模式上,除傳統的非正式照顧外,機構照顧是其另一重要的選擇,故機構是否提供完善的設施與服務,關係老人進住的權益與福利,亦是政府推行老人福利政策所關切的。因此,如何督導機構經營與管理,幫助其改善經營效率並提升服務品質,以提供老人適切的住所,落實老人福利政策,並讓政府支出運用在最有效率的地方,實屬重要的課題。
本研究希望藉由資料包絡分析法,對老人福利機構經營績效進行分析,以期找出影響經營績效之因素及無效率機構應改善之方向及幅度,提供機構經營改善及主管機關監督輔導之參考。研究選取之投入變數有床位數、人事費、給養費、總支出、醫護人員、照顧人員及其他人員,產出變數有收容人數、服務收入、照顧服務、環境設施及總收入。在效率影響因素分析上,採用Tobit 截斷迴歸方法,應變數為機構經營效率值,而選取之解釋變數包括床位數、收容率、工作人員比率、補助別虛擬變數及營運期間等五項。
研究結論與建議摘述如次:
一、老人福利機構規模差異性大,人事費用與給養支出為主要成本,而收入主要來源除服務收入外,尚有政府補助及委辦收入。因此,為求基準一致,評估機構經營效率時,應將政府補助及委辦收入排除。
二、機構照顧服務品質對經營效率具有影響,當納入品質變數後各單位相對效率值差異會縮小。因此,評估機構經營效率時,應考慮機構照顧服務品質。
三、中央主管機構來自政府補助及委辦收入相對較其他機構多,但在效率值、照顧服務品質、投入資源運用及產出目標達成上表現卻相對較差。
四、財團法人機構在照顧服務品質、床位資源運用及各項產出目標達成上均表現相對較差;公立機構則在經費支用上表現相對較差。
五、接受政府補助及委辦機構在經營效率表現上相對較差,值得主管機關加強輔導並檢討補助及委辦對象,以免造成資源錯置浪費。
六、機構床位數、收容率、工作人員比率及是否接受補助等變數對經營效率具有顯著影響。因此,機構經營者可藉由調整床位規模、提高收容率及調整適當之工作人員配置比率來提高經營效率。
關鍵詞:老人福利機構經營效率、資料包洛分析法、Toibit迴歸分析

As the aging of population increases in pace our country is striding towards becoming a highly aged society with the support of the aged evolving new social needs. In the different approaches of care for the aged, besides traditional informal care, organizational care is another important option, albeit the adequacy of facilities and services provided by the organizations in relation to the rights and welfare of the aged upon residency, are all critical concerns of the aged welfare policy that the government is pushing forward. Therefore, how to provide supervision and guidance to the operation and management of these organizations, assistance with the improvement of operational efficiency and to raise the service quality, in order to provide a conducive living quarters for the aged, as well as realizing the aged welfare policy, and letting the government disburse and apply to the most efficient areas, are indeed vital topics of discussion.
The present study hopes to carry out analysis of the achievements of aged welfare organizations through Data Envelopment Analysis, to find out the factors influencing the efficiency of operations as well as the directions and depth of improvement needed to be adopted by inefficient organizations, to be provided as references for the operational improvement of organizations and supervisory guidance of governing organizations. The input variables adopted by the study includes number of beds, human resource expenses, alimony fees, total expenses, medical care personnel, care personnel and other personnel; output variables includes number of accepted person, service income, caring service, environmental facilities and total income. In Analysis of Factors Affecting, we adopted Tobit Censored Regression method, dependent variable being the efficiency value of the organizational operation, and the selected explanatory variable includes the five variables of number of beds, admittance ratio, comparison ratio of working personnel, fictitious subsidy variable and operational period.
Study Conclusion and Suggestion Summary as follows:
1. The divergence in size of aged welfare organization is great, human resource expenses and alimony payouts are the main costs, while the main source of income besides services income, also include government subsidies and commission income. Therefore, in order to have uniform standards, government subsidies and commission income shall be excluded when assessing the operational efficiency of the organizations.
2. The care quality of organizations has influence on the operational efficiency, the divergence of corresponding efficiency value of respective units after incorporating quality variable shall narrow. Thus, the care quality of organizations shall be considered when assessing the operational efficiency of organizations.
3. Income from government subsidies and commission income of central governing organizations is relatively more than other organizations, however performances on efficiency value, quality of care services, application of invested resources, as well as achievement of output objectives is relatively poorer.
4. Performances of institutional organizations on the quality of care services, application of bed resources and achievement of various output objectives is relatively poorer; while the performances of publicly established organizations on the application of budgetary expenses is relatively poorer.
5. Admittance of government subsidies and authorized organizations perform relatively poorer on operational efficiency, worthy of governing organizations to enhance supervisory guidance and review the recipients of subsidies and authorized establishments, to avoid causing resources to be wrongly allocated and wasted.
6. The variables of number of beds, admittance ratio, personnel ratio and if subsidies is accepted, of organizations have significant influence on operational efficiency. Therefore, operators of organizations may lift operational efficiency through adjusting the scale of number of beds, raising the admittance ratio and reshuffling the deployment ratio of suitable personnel.
Keywords: Operational efficiency of elderly welfare institution,
data envelopment analysis, Tobit regression analysis
URI: http://hdl.handle.net/11455/27626
其他識別: U0005-2408200613012600
Appears in Collections:應用經濟學系

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